36例回旋支为梗死相关动脉的急性下壁心肌梗死的心电图特点

目的分析回旋支为梗死相关动脉的急性下壁心肌梗死(简称心梗)的心电图表现,总结其心电图特点。方法回顾性分析本院经冠状动脉造影证实回旋支为梗死相关动脉的急性下壁心梗患者36例,分为ST↑Ⅲ<Ⅱ组(n=8),ST↑Ⅲ=Ⅱ组(n=19)和ST↑Ⅲ>Ⅱ组(n=9)三组,分析发病12 h内的18导联心电图特点。比较三组冠状动脉优势型及病变部位。结果 ST↑Ⅲ<Ⅱ组STⅠ、aVL抬高、等电位线、压低的发生率分别为50%,12.5%,37.5%;ST↑Ⅲ=Ⅱ组相应的发生率分别为10.5%,31.6%,57.9%;ST↑Ⅲ>Ⅱ组相应的发生率分别为0,11.1%,88.9%。ST↑Ⅲ<Ⅱ组STV4-6抬高、等电位线、压低的发生率分别为87.5%,0,12.5%;ST↑Ⅲ=Ⅱ组相应的发生率分别为78.9%,21.1%,0;ST↑Ⅲ>Ⅱ组相应的发生率分别为66.7%,0,33.3%。三组患者冠状动脉优势型的比较有差异(P<0.05),三组STV7-9形态、STV3R-5R形态、冠状动脉病变部位无差异(P均>0.05),三组均无房室传导阻滞的发生。结论回旋支为梗死相关动脉的急性下壁心梗ST↑Ⅲ<Ⅱ时常合并STⅠ、aVL抬高,ST↑Ⅲ=Ⅱ、ST↑Ⅲ>Ⅱ时常合并STⅠ、aVL压低;回旋支为梗死相关动脉的急性下壁心梗累及右室时也可表现为ST↑V3R-5R;回旋支为梗死相关动脉的急性下壁心梗不易发生房室传导阻滞。

Electrocardiographic characteristic of thirty six cases of acute inferior myocardial infarction with left circumflex artery as the infarction-related coronary artery.

Objective To analyze electrocardiographic characteristic of patients with angiographically documented left circumflex artery(LCX) as the infarction-related coronary artery in the setting of acute inferior myocardial infarction.Methods Retrospective analysis of thirty six cases of electrocardiographic characteristic with angiographically documented LCX as the infarction-related coronary artery,patients were devided into ST↑Ⅲ<Ⅱ group(n=8),ST↑Ⅲ=Ⅱ group(n=19) and ST↑Ⅲ>Ⅱ group(n=9),all patients were admitted in 12 hours and 18 lead electrocardiogram was recorded.Results Within ST↑Ⅲ<Ⅱ group,incidence rate of STⅠ,aVL elevation,isopotential,depression were 50%,12.5%,37.5%,respectively;Within ST↑Ⅲ=Ⅱ group,incidence rate were 10.5%,31.6%,57.9%,respectively;Within ST↑Ⅲ>Ⅱ group,incidence rate were 0,11.1%,88.9%,respectively.Within ST↑Ⅲ<Ⅱ group,incidence rate of STV4-6 elevation,isopotential,depression were 87.5%,0,12.5%,respectively;Within ST↑Ⅲ=Ⅱ group,incidence rate of STV4-6 elevation,isopotential,depression were 78.9%,21.1%,0,respectively;Within ST↑Ⅲ>Ⅱ group,incidence rate of STV4-6 elevation,isopotential,depression were 66.7%,0,33.3%.There were statistical significance of coronary artery dominant types among the three groups(P<0.05),and no statistical significance of STV7-9,STV3R-5R and coronary artery lesion among the three groups(all P>0.05).There were no atrioventricular block occurence among the three groups.Conclusions Among patients with acute inferior myocardial infarction with LCX as the infarction-related coronary artery,ST↑Ⅲ<Ⅱ always with the combination of STⅠ,aVL elevation,ST↑Ⅲ=Ⅱ,ST↑Ⅲ>Ⅱ always with the combination of STⅠ,aVL depression;Acute inferior myocardial infarction with LCX as the infarction-related coronary artery can aslo involve the right ventricle,lead to STV3R-5R elevation;Acute inferior myocardial infarction with LCX as the infarction-related coronary artery barely lead to atrioventricular block.