急性前壁心肌梗死心电图对左冠状动脉前降支病变的诊断价值

The diagnostic value of electrocardiogram for the site of culprit in left anterior descending coronary artery during acute anterior wall infarction

目的探讨心电图在ST段抬高型急性前壁心肌梗死时左冠状动脉前降支(LAD)病变部位的诊断价值。方法对89例经冠状动脉造影证实前降支为梗死相关动脉患者的18导联心电图进行回顾性分析。结果心电图STV2抬高≥3mm、STV3抬高≥2mm、STⅡ,Ⅲ,avF压低≥1mm对前降支近段闭塞的判断有较大的价值,其阳性率与前降支远段闭塞组差异有显著性意义,其诊断的特异性和敏感性均较高。结论ST段抬高型急性前壁心肌梗死时体表心电图与左冠状动脉前降支闭塞部位有明显相关性。

Objective To assess the diagnostic value of electrocardiogram （ECG） for the site of culprit in left anterior descending coronary artery （LAD） during acute anterior wall myocardial infarction with ST segment elevation. Methods 89 of patients＇s 18 leads ECG were retrospectively analyzed, while the result of infarctrelated artery（IRA） in LAD had been confirmed by coronary arteriongraphy（CAG）. Results ECG such as STV2 elevation≥3mm, STV3 elevation≥2mm and STⅡ ,Ⅲ, avF depressions〉 lmm have the major value in judgement of left anterior descending coronary artery occlusion in proximal segment, and has significant difference compared with left anterior descending coronary artery occlusion in distal segment. Conclusion There is significant correlation between ECG and the site of culprit in left anterior descending coronary artery during acute anterior wall myocardial infarction with ST segment elevation.