心电图对急性下壁心肌梗死患者梗死相关血管及闭塞部位的预测价值

目的:探讨急性下壁心肌梗死患者的体表心电图对梗死相关血管及闭塞部位的预测价值。方法:对62例急性下壁心肌梗死患者的体表心电图和冠状动脉造影资料进行回顾性对比分析。结果:梗死相关血管为右冠状动脉者50例(80.65%),左回旋支者12例(19.35%)。单纯急性下壁心肌梗死多发生在右冠状动脉中远段(62.07%);并发右室梗死者均发生在右冠状动脉,且多发生在右冠状动脉近段(70.00%)。STⅢ抬高/STⅡ抬高>1、STaVL压低≥0.5mm、STV1抬高≥0.5mm、STV3压低/STⅢ抬高≤1.2提示梗死相关血管为右冠状动脉的灵敏度分别为88.00%、90.00%、66.00%、72.00%,特异度分别为58.33%、75.00%、83.33%、66.67%。STⅢ抬高/STⅡ抬高≤1、STaVL呈等电位线或抬高、STV1压低≥0.5mm、STV3压低/STⅢ抬高>1.2提示梗死相关血管为左回旋支的灵敏度分别为58.33%、75.00%、66.67%、66.67%,特异度分别为88.00%、90.00%、80.00%、72.00%。结论:急性下壁心肌梗死时,体表心电图对梗死相关血管及闭塞部位有重要的预测价值。

Value of electrocardiogram in predicting infarct-related-artery and the location of occlusion in patients with inferior wall acute myocardial infarction

Objective:To investigate the value of electrocardiogram(ECG) in predicting infarct-related-artery(IRA) and the location of occlusion in patients with inferior wall acute myocardial infarction(IAMI).Method:The data of ECG and coronary angiographic findings in 62 patients with IAMI were retrospectively comparative analyzed.Result:IAMI was caused by right coronary artery(RCA) in 50(80.65%) cases and by left circumflex artery(LCX) in 12(19.35%) cases.The location of RCA occlusion often occurred at the middle or distal segment in patients with simple IAMI(62.07%).In patients with concomitant right ventricular infarction,the IRA was always RCA,and the location of RCA occlusion often occurred at the proximate(70.00%).STⅢ elevation/STⅡ elevation>1,STaVL depression≥0.5 mm,STV1 elevation ≥0.5 mm and STV3 depression/STⅢ elevation≤1.2 identified RCA occlusion,the sensitivities were 88.00%,90.00%,66.00% and 72.00%,the specificities were 58.33%,75.00%,83.33% and 66.67%;STⅢ elevation/STⅡ elevation≤1,STaVL isoelectric level or elevation,STV1 depression ≥0.5 mm and STV3 depression/STⅢ elevation>1.2 identified LCX occlusion,the sensitivities were 58.33%,75.00%,66.67% and 66.67%,the specificities were 88.00%,90.00%,80.00% and 72.00%.Conclusion:ECG has significant value in predicting the IRA and the location of occlusion in IAMI.