心电图J/R比值对下壁心肌梗死并发房室阻滞的预测价值

The diagnosis value of J/R rario to the acute inferior myocardial infarction with atrial ventricular block

目的探讨急性下壁心肌梗死早期心电图表现对高度房室阻滞的预测价值以及与冠状动脉病变的关系。方法分析97例急性下壁心肌梗死患者早期心电图(下壁导联)J/R≥0.5的发生情况,部分病例结合冠脉造影结果,探讨其对房室阻滞的预测价值。结果27例(21.6%)在心肌梗死急性期发生二度以上房室阻滞。有房室阻滞者,心电图下壁导联J/R≥0.5多于无房室阻滞者(69.56% vs 30.44%,p<0.01)。冠状动脉造影显示,有房室阻滞者,右冠状动脉近中段的高度狭窄明显多于无房室阻滞者(100% vs 58.33%)。结论急性下壁心肌梗死伴房室阻滞者的病损冠脉以右冠状动脉多见,下壁导联心电图J/R≥0.5对下壁心肌梗死合并房室阻滞的发生有一定的预测价值。

Objective To explore the predictive value of ECG features in early stage of acute inferior myocardial infarction as indicators of developing high-degree （second- or third- degree） atrioventricular block and their relationship with the possible coronary disease. Methods Analyze the ECG features of early stage of acute inferior myocardial infarction in 97 senior patients. The results were compared with coronary angiography in some cases. Results 27 patients （21.6%） had high-degree AV block in the acute stage of myocardial infarction. Patients with high-degree AV block had high ratio of J/R≥0.5 than the patients without AV block（69.56% vs 30.44%, p〈0.01）. The results of coronary angiography showed the patients with AV block had high ratio of stenosis 〉50% in proximal and median segments of right coronary artery than the patients without AV block （100% vs 58.33%）. Conclusion Atrioventricular nodal artery was critical in the developing of AV block. J/R ≥ 0.5 can predict the developing of AV block in inferior myocardial infarction.