前壁导联ST段压低与急性下壁心肌梗死冠脉病变状况及预后的关系

目的探讨前壁导联ST段压低与急性下壁心肌梗死（MI）冠脉病变程度及预后的关系。方法根据MI初期是否并发前壁导联ST段压低将96例急性下壁MI分为两组即前壁导联ST段压低组（A组,56例）和前壁导联ST段无压低组（B组,40例）,将两组冠脉造影结果、梗死部位及预后进行比较分析。结果A组多支血管病变（52%）、梗死相关血管近端病变（82%）,下后壁MI（88%）、下后壁+右室MI（90%）,心力衰竭（16%）、心源性休克（14%）、室速（21%）。B组多支血管病变（30%）、梗死相关血管近端病变（22%）,下后壁MI（12%）、下后壁+右室MI（10%）,心力衰竭（2%）、心源性休克（2%）、室速（8%）。两组分项比较差异均显著（均P<0.05）。结论并发胸前导联ST段压低的急性下壁MI多为多支血管病变,梗死相关血管多为近端病变,梗死部位多,预后不良。

Relationship between severity of coronary artery disease, its prognosis and ST-segment depression on anterior wall during acute inferior wall myocardial infarction

AIM To explore the relationship between the severity of coronary artery disease, its prognosis and ST-segment depression on anterior wall during acute inferior myocardial infarction (AIMI). METHODS Ninety-six patients with AIMI were divided into two groups: ST depression group (group A, n=56) and no-ST depression group (group B, n=40) based on ST-changes in the anterior leads. The data of both groups were compared with the coronary angiographic findings, the section of myocardial infarction and prognosis. RESULTS The cases with multi-vessel lesions (52%), proximal lesions of infarction related artery (82%), inferior-posterior AMI (88%), inferior-posterior AMI accompanied by right ventricular infarction (90%), heart failure (16%), cardiogenic shock (14%), ventricular tachyrhythmia (21%) in group A were more than those in group B. CONCLUSION Multi-vessel disease, proximal lesion of infarction related artery, multi-section of myocardial infarction, and poor prognosis are more likely to occur in a patient of AIMI with ST-segment depression on anterior wall.