急性下壁合并右心室心肌梗死的心电图诊断价值

Diagnostic value of electrocardiogram in patients with acute inferior wall and right ventricular myocardial infarction

目的探讨急性下壁合并右心室心肌梗死的心电图诊断价值。方法71例急性下壁心肌梗死患者按冠状动脉造影结果分为合并右心室心肌梗死组(观察组,31例)和未合并右心室心肌梗死组(对照组,40例),进行12导联及右胸导联心电图检查,分析STV3R～V6R抬高≥1mm、STⅢ/STⅡ抬高≥1及两项联合对急性下壁合并右心室心肌梗死的诊断价值。结果观察组ST段抬高3项指标阳性率均明显高于对照组(P<0.05),其敏感性分别为90.32%、83.87%和80.65%;特异性分别为95.00%、92.50%和97.50%。两项指标联合可获较高特异性及阳性预测值。结论心电图STV3R～V6R抬高≥1mm及/或STⅢ/STⅡ抬高≥1有助于急性下壁合并右心室心肌梗死的临床诊断。

Objective To evaluate diagnostic value of electrocardiogram in patients with acute inferior wall and right ventricular myocardial infarction（IWMI and RVMI）. Methods 71 cases with acute IWMI were divided into group A（n =31, IWMI with RVMI） and group B（n =40, IWMI without RVMI） according to results of coronary angiography. ST V3R-V6R lmm, ratio of STⅢ / STⅡ≥ lot the combination of above two were used as indicators of IWMI with RVMI. Results All the three indicators were seen significantly more in group A than in group B （P〈0.05）. Sensitivity and specificity of the three indicators for diagnosing IWMI with RVMI was 90.32%, 83.87% and 80.65%,and 95.00%, 92.50% and 97.50%,respectively. Conclusion ST V3R-V6R≥ lmm and / or ratio of ST Ⅲ / ST Ⅱ≥ 1 on electrocardiogram may be used to diagnose IWMI with RVMI.