判断急性下壁心肌梗死罪犯血管的心电学新标准

为验证心电图aVL导联QRS波群变化能否作为下壁急性心肌梗死 (AMI)罪犯血管的判定标准 ,比较 6 0例下壁AMI患者aVL导联QRS波群变化与冠状动脉造影结果的相关性 ,分析aVL导联QRS波群两种模式 (Ⅰ型 :S/R≤1/ 3,ST段抬高≤ 1mm ;Ⅱ型 :S/R >1/ 3,ST段抬高 >1mm)对判断下壁AMI罪犯血管的临床价值。结果 :aVL导联的Ⅰ型QRS波群改变在左冠状动脉回旋支闭塞 (LCX)组出现率为 89% ,右冠状动脉闭塞组为 2 4% (P <0 .0 0 1)。Ⅱ型改变在LCX组出现率为 11%、RCA组为 76 % (P <0 .0 0 1)。Ⅰ型心电图变化预测LCX闭塞的敏感度为 89%、特异性为 76 %。Ⅱ型心电图改变预测RCA闭塞的敏感度为 76 %、特异性为 89%。结论 :aVL导联的Ⅰ型QRS波群变化是判断LCX型AMI敏感、特异的预测指标 ,而Ⅱ型QRS波群变化是RCA型AMI有效的预测指标

New Electrocardiographic Cr iteria for Predicting The Culprit Artery in Inferior Myocardial Infarction

To test and verify if the culprit artery in inferior wall acute myoca rdial infarction(AMI) can be predicted by the configuration of the QRS complex In lead aVL,the relation between the configuration of the QRS complex in lead aV Land the results of coronary angiography was studied in 60 inferior wall AMI patient,the values of the two pattern (pattern Ⅰ:S/R wave ratio≤1/3，ST elevatio n ≤1 mm；pattern Ⅱ：S/R wave ratio >1/3，ST elevation>1 mm)in predicting the c ulprit artery of inferior wall AMI patient were investigated.Results:Pattern Ⅰ of QRS complex in lead aVL was found in 89% of the left circumflex (LCX) group compared with 24% of the right coronary artery(RCA) group（P<0.001）.Pattern Ⅱ was found in only 11% of the LCX group compared with 76% of the RCA group（ P<0.001）.Pattern Ⅰhad a sensitivity of 89% and specificity of 76% to pred ict LCX related AMI.Pattern Ⅱhad a sensitivity of 76% and specificity of 89% t o predict RCA related AMI.Conclusions: Pattern Ⅰ of QRS complex in lead aVL is a sensitive and specific marker for LCX artery AMI,whereas pattern Ⅱ is suggest ive of RCA-related AMI disease.