16导联心电图ST段改变对急性心肌梗死的临床价值

目的探讨16导联心电图中ST段改变对急性心肌梗死的临床诊断价值。方法对332例急性心肌梗死患者,在原有标准12导联的基础上,增加后壁导联（V7和V8）和右胸导联（V4R和V5R）,观察附加导联中ST段改变,是否可提高心电图诊断急性心肌梗死的价值。结果12导联心电图诊断急性心肌梗死的敏感性为71.4%,特异性为86.0%;12导联＋后壁导联诊断急性心肌梗死的敏感性为79.2%,特异性为85.0%;12导联＋右胸导联诊断急性心肌梗死的敏感性为75.3%,特异性为84.5%;12导联＋后壁＋右胸导联诊断急性心肌梗死的敏感性为81.9%,特异性为83.7%。结论增加后壁和右胸导联可提高诊断急性心肌梗死的敏感性,而特异性并无显著降低。

Clinical value of ST segment change in 16-lead ECG for diagnosing acute myocardial infarction

Objective To investigate the clinical value of 16-lead ECG in diagnosing acute myocardial infarction. Methods 16-lead ECG, in which added posterior precordial leads V7 and V8 and right preeordial leads V4R and V58 to standard 12 leads, was recorded in 332 patients with acute myocardial infarction. For detection of acute myocardial infarction, the valve of ST segment change in additional posterior and right precordial leads comparison with standard 12 leads was observed. The hypothesis that the additional leads could improve the diagnostic valve of ECG in acute myocardial infarction was assessed. Results The sensitivity and specificity for diagnosis acute myocardial infarction, in 12 leads was 71.4% and 86.0%, in 12-lead ＋ posterior leads was 79.2% and 85.0%, in 12-lead ＋ right precordial leads was 75.3% and 84.5%, and in 16-lead was 81.9% and 83.7%, respectively. Conclusion The additianal posterior and right preeordial leads increased the sensitivity hut did not decrease specificity of ECG for the detection of acute myocardial infarction.