急性前壁心肌梗死并下壁导联ST段压低与冠状动脉病变的关系

目的：观察急性前壁心肌梗死下壁导联ＳＴ段压低与冠状动脉病变的关系。方法：对６６例急性前壁心肌梗死患者均常规行冠状动脉造影术，根据常规心电图下壁导联ＳＴ段压低＞１ｍｍ分为ＳＴ段压低组（４８例）与ＳＴ段正常组（１８例），比较分析心电图与冠状动脉造影之间的关系。结果：急性前壁心肌梗死患者２７．３％有下壁导联ＳＴ段压低，ＳＴ段压低组中冠状动脉病变支数与正常组无显著性差异（Ｐ＞０．０５），７３．２％为左前降支（ＬＡＤ）近端病变，显著高于ＳＴ段正常组（４５．８％）。ＳＴ段压低组５５．６％伴有心电图ＳＴＩ，ａＶＬ抬高，显著高于ＳＴ段正常组（４．２％）（Ｐ＜０．０１）。结论：急性前壁心肌梗死并下壁导联ＳＴ段压低与冠状动脉病变支数无关，而与ＬＡＤ近端病变有关，可能反映高侧壁心肌缺血时的心电图对应性改变。

Relationship between inferior ST-segment depression and coronary artery lesions in acute anterior myocardial infarction

Objective: To study the relationship between inferior ST segment change and coronary artery lesions in acute anterior myocardial infarction. Method: Routine angiography was done in all of 66 patients with acute anterior myocardial infarction.The patients are divided into inferior ST segment depression group(18 patients) and normal inferior STsegment group(48 patients) depending on weather inferior ST depression>1 mm.The relationships between inferior ST depression and coronary angiographic results were analysed. Result: 27.3% of patients with acute anterior myocardial infarction had STsegment depression in inferior leads.The ST depression in inferior leads did not relate with number of coronary lesions.73.2% of patients with proximal left anterior descending(LAD) coronary lesionsoccurred in ST depression group,which was significantly higher than normal ST segment group(45.8%,P<0.05).55.6% of patients were accompanied by STI,aVL elevation in STsegment depression group,which was significantly higher th infarctionan normal ST segment group(4.2%,P<0.01). Conclusion: The inferior STsegment depression in acute anterior myocardial infarction was not associated with multivessel lesions,but with proximal LAD lesion, and might represent reciprocal changes of ischemia of high anterolateral region.