急性前壁心肌梗死时体表心电图初步预测前降支闭塞部位

目的：探讨前壁、广泛前壁急性心肌梗死（AMI）患者体表心电图（ECG）改变与梗死相关动脉（IRA）定位的关系。方法选择该院2008年1月1日至2013年3月31日期间入院的AMI患者171例，将患者分为近段组和中远段组，对患者的ECG与冠状动脉照影（CAG）的资料进行回顾性对比分析。结果STI、aVL抬高、STⅡ、Ⅲ、aVF压低、STaVR导联抬高时提示前壁、广泛前壁AMI的IRA为左前降支（LAD）近端闭塞而不是中远端闭塞的可能性较大（P＜0．05）。结论解读有价值的ECG指标，能初步推测前壁AMI的IRA及其闭塞部位。

The preliminary prediction of the occlusion site of left anterior descending branch through electrocardiogram in anterior acute myocardial infarction

Objective To investigate the orientation relationship between the infarct related artery (IRA)and the change of the electrocardiogram (ECG)of the patients with anterior wall and extensive anterior wall acute myocardial infarction (AMI) .Methods ECG and coronary artery angiography (CAG)were compared and analyzed retrospectively through 171 patients(selected from January 1 ,2008 to March 31 ,2013)who were divided into anterior wall of LAD group and extensive anterior wall of LAD group .Re‐sults It was prompted that the IRA of the extensive anterior was the proximal occlusion of the left anterior descending (LAD) rather than distal occlusion (P<0 .05)if ST‐segment elevated in lead I ,aVL and aVR or ST‐segment depressed in lead Ⅱ ,Ⅲ and aVF in case of anterior wall and extensive anterior wall AMI .Conclusion Analyzing valuable ECG index could help us to prelimina‐rily infer IRA and the occlusion site in anterior wall and extensive anterior wall AMI .