心电图QRS综合波改变对早期诊断急性下壁心肌梗死的意义

The early diagnostic value of QRS complex wave changes of electrocardiogram in acute inferior myocardial infarction

目的通过胸痛患者连续心电图监测,以便早期确诊急性下壁心肌梗死。方法在30例患者中,根据胸痛开始5h内连续描记常规12个导联心电图,测定各导联R波、S波振幅及ST段变化,与心肌梗死前正常心电图作比较。结果所记录的心电图改变中,Ⅱ、Ⅲ、aVF导联QRS波群的S波消失,出现高尖R波,下壁心肌梗死aVL导联S波的改变也有重要诊断意义。结论急性下壁心肌梗死早期心电图最显著的改变,表现在Ⅲ、aVF、aVL导联QRS综合波终末电压的增高。

Objective To study the early diagnostic value of acute inferior myocardial infarction （AI- MI） with continued electrocardiogram（ECG） monitoring in patients suffered from chest pain. Methods 30 patients with AIMI underwent continued 12-lead of ECG monitoring within 5 hours after the symptom onset. The changes of R and S waves amplitude and ST segment were observed and compared with those normal ECG before acute myocardial infarction occured. Results From all recorded changes of ECGs, our results showed that S wave disappeared and higher R wave arised in leads Ⅱ , Ⅲ,aVF, and the change of S wave in lead aVL also had important diagnostic value. Conclusion Terminal force elevation of QRS wave in leads Ⅲ, aVF, aVL is the most remarkable change in early ECG of AIMI.