93例急性心肌梗死患者的心电图及冠脉造影分析

目的探讨急性心肌梗死患者心电图sT改变的导联与冠状动脉罪犯血管的关系。方法对93例急性心肌梗死患者心电图ST段改变与选择性冠状动脉造影结果进行对比分析。结果心电图V1-V4sT抬高伴Ⅱ、Ⅲ、aVFST段下移的罪犯血管主要为左前降支（LAD），少数前壁心肌梗死伴下壁sT段抬高；Ⅱ、Ⅲ、aVFST抬高伴V1-V4 ST段下移的主要罪犯血管为右冠状动脉（RCA），少部分为左回旋支（LCX），极少部分为LAD；胸前导联T高尖与ST抬高导联不一致可排除LAD；高侧壁Ⅰ、AVLST段抬高多数罪犯血管为LCX。结论心电图ST改变的导联对急性心肌梗死罪犯血管能进行初步预测。

Analysis of 12-lead electrocardiogram(ECG) and coronary angiography(CAG) in patients with acute myocardial infarction

Objective To study the correlation between 12-lead surface ECG and the culprit artery oc- clusion by the coronary angiography （CAG） explored. Methods Patients with acute myocardial infarction （n=93） were included to this Trial. A 12-lead surface electrocardiogram was obtained in patients who had acute myocardial infarction and subsequently underwent coronary angiography（CAG） to identify the culprit vessels. Results ST V1-V4 elevation and STⅡ, STⅢ, STAAVF depression predict LAD coronary artery occlusion, ST Ⅱ, STⅢ, STAVF elevation and STw-v4 depression is associated with RCA occlusion, fewer of culprit artery was LCX, a little was LAD. Peaked and tall T wave accompanied with ST elevation in lead V1-V6 manifest LAD occlusion, ST Ⅰ, STAVLE elevation predicted LCX. Conclusion ST segment changes in 12-lead ECG might identify the culprit artery of acute my- ocardial infarction.