头胸导联右胸心电图在右心室梗塞时的变化

THE CHANGES IN HEAD CHEST LEAD OF RIGHT PRECORDIAL ECG IN RIGHT VENTRICULAR MYOCARDIAL INFARCTION

为探讨头胸导联右胸心电图诊断右心室梗塞的价值,作者对39例患者V_(3R)～V_(9R)右胸导联描记头胸和常规心电图,其中Ⅰ组10例,冠状动脉造影正常,Ⅱ组前壁梗塞17例,Ⅲ组下壁梗塞6例,Ⅳ组急性下壁合并右心室梗塞6例(Ⅱ、Ⅲ、Ⅳ组右冠状动脉狭窄人数分别占23.5％、100％、100％)。右胸导联出现病理Q波(Q≥1/4R、t>0.04s)在头胸导联为0、5％、73.8％及100％,在常规导联为57％、37.8％、71.4％及100％。两种导联方法在Ⅰ组和Ⅱ组的Q波出现率呈显著差异(P均<0.01)。显示头胸导联右胸心电图诊断急性右心室梗塞明显优于常规导联,并有希望对陈旧左室梗塞波及部分右心室提供诊断线索。

In order to study the value of head chest (HO lead ECG in diagnosis of right ventricular infarction (RVI) the right precordial leads V3R-V9R ECG of HC lead and conventional lead were obtained in 39 cases.The patients were divided into four groups:group I 10 cases (coronary angiogram normal),group I anterior myocardial infarction (MI) 17 cases,group Ⅲ inferior MI 6 cases and group Ⅳ acute inferior and RVI 6 cases (incidence of right coronary artery stenosis in groups Ⅱ,Ⅲ,Ⅳ were'lesion 23.5%,100% and 100% respectively).The incidence of abnormal Q wave (Q>1/4R,t>0.04s)in the HC leadswas 0,5%,73.8% and 100% respectively,and in the conventional lead 57.0%.37.8%,71.4% and 100%,respectively,for the 4 groups.The significant differences were observed among groups Ⅰ and Ⅲ(P<0.01,P<0.01)The HC lead of right precordial ECG was more accurate than the conventional lead ECG in the diagnosis of acute RVI and it was hopeful to obtain the clues for the diagnosis of involvement of right ventricle in old left ventricular MI.