心电图对急性下壁心肌梗死患者梗死相关血管的判定价值

The value of electrocardiogram in identifying the infarct-related artery in patients with inferior wall acute myocardial infarction

目的探讨常规心电图在急性下壁心肌梗死(下壁AMI)患者梗死相关血管(IRA)判定中的价值。方法分析42例首次下壁AMI者的心电图与冠脉造影资料,计算心电图指标A:STⅡ抬高/STⅢ抬高比值<1,STI低于等电位线和指标B:STⅡ抬高/STⅢ抬高>1,STI位于或高于等电位线预测右冠状动脉(RCA)或左旋支(LCX)系IRA的敏感性、特异性、阳性和阴性预测值。结果心电图指标A预测RCA为下壁AMI者IRA的敏感性、特异性、阳性及阴性预测值分别为89%、90%、96.2%、90%;心电图指标B预测LCX为IRA的敏感性、特异性、阳性及阴性预测值分别为90%、93%、75%、89%。结论在首次下壁AMI患者,常规心电图指标能较准确的预测IRA。

Objective To investigate the value of conventional electrocardiogram in identifying the infarct-related artery(IRA)in patients with inferior wall acute myocardial infarction(AMI).Methods The electrocardiogram and results of coronary angiograpy in 42 patients with first inferior wall AMI were analysed and the sensitivity,specificity,positive predictive value and negative predictable value of electrocardiographic parameter A: STⅡelevation/STⅢelevation <1,ST I depressed for identifying right coronary artery(RCA)as IRA and parameter B:STⅡelevation /STⅢ elevation>1,ST I being isoelectrical or elevated for identifying left circumflex(LCX)as IRA were made out.Results The sensitivity,specificity, positive and negative predictable value of electrocardiographic parameter A in identifying RCA as IRA was89%,90%,96.2%,90% respectively,and the parameter B in identifying LCX as IRA was 90%,93%,75%,89% respectively.Conclusion Electrocardiographic parameters can be used to identify the IRA accurately in patients with first inferior wall AMI.