急性下壁心肌梗塞高危亚群的识别

Identification of High Risk Subgroup of Patients with Acute Inferior Myocardial Infarction

观察95例急性下壁心肌梗塞(AIMI)患者的临床表现、心电Ⅱ导R/Q比值、胸前导联ST段压低范围及幅度、心肌酶、心功能、心律失常等情况.结果显示在AIMI时.Ⅱ导的R/Q比值<1,伴有Ⅱ度以上的房室传导阻滞、胸前导联ST段压低的范围广且程度重、合并右室梗塞等,均为AIMI的高危亚群.它们虽可独立存在,都不能作为高危亚群的唯一标志.在预后判断上,其意义相似.任一指标合并存在,均应引起足够重视.

We examined 95 patients with acute inferior myocardial infarction (AIMI). The clinical manifestation,the ECG lead I R/Q ratio,the extent and amplitude of the ST segment depressing in the chest leads,the serum myocardial enzymes,the heart function,andthe arrhythmia were studied. The result showed that the ECG lead I R/Q<1,presence of grade Ⅱ A-V block and over that,marked depression of ST segment of chest leads ,the com-plication of right ventricle infarction and so on,all of them indicates the high risk subgroup of AIMI and may be present independently, but any one of them can not be considered as the only index of the high risk subgroup of AIMI. The significance of the indices in prognosis is similar to that in diagnosis,and the combinations of two indices or more should be empha-sized.