急性前壁心肌梗死患者下壁导联ST变化和左前降支的关系

Different Inferior wall ST-segment deviation on the initial electrocardiogram in patients with anterior wall acute myocardial infarction is related with anterior descending branch

目的:结合冠状动脉造影(CAG)探讨下壁导联ST变化和左前降支(LAD)形态和梗死位置的关系。方法:78例急性前壁心梗患者,根据入院时心电图下壁导联ST段改变分为2组:A组为下壁导联(Ⅱ、Ⅲ、AVF)ST段抬高组;B组为下壁导联ST段压低组。比较二组临床特点和梗死相关血管(IRCA)。结果:IRCA部位A组90.63%为LAD远端,B组80.43%为LAD近端;LAD折返在A组占81.25%,B组中占0%。结论:急性前壁心肌梗死时下壁导联ST段压低提示LAD近端梗死,此组患者急诊PCI术成功率高。急性前壁心肌梗死时ST段抬高提示LAD远端梗死且大部分存在LAD返折。

Objective：To evaluate relationship between different inferior wall ST-segment deviation on the initial electrocardiogram in patients with anterior wall acute myocardial infarction and lesion spite and length of anterior descending branch according to coronary arteriongraphy. Methods：According to different inferior wall ST-segment deviation, seventy-eight patients with anterior wall AM1 were divided into two groups：Group A,inferior ST-segment elevation;Group B,inferior ST-segment depression. To Compare its clinical feature and infarction related coronary artery（IRCA） between two groups. Results：As for IRCA,90.63% of group A suffered distal lesion of left anterior descending artery （LAD）;80.43% of group B suffered proximal lesion of LAD. 81.25% of group A had reentry of LAD.0% of group B had reentry of LAD. Conclusion： Inferior wall ST-segment depression on the initial electrocardiogram in patients with anterior wall acute myocardial infarction indicated proximal lesion of anterior descending branch. PCI operation success rate of the group B was higher. Inferior wall ST-segment elevation in initial electrocardiogram in patients with inferior wall acute myocardial infarction indicated distal lesion of ALD and reentry of ALD.