急性下壁心肌梗死心电图的改变与相关冠脉病变的关系

Relationship Between the Change of Electrocardiogram and Infarct-related Artery Lesion in Acute Inferior Myocardial Infarction

[目的]探讨急性下壁心肌梗死时心电图ST段改变对判断心肌梗死相关冠状动脉病变的关系.[方法]对50例急性下壁心肌梗死ST段改变与冠状动脉造影结果对比分析.[结果]①血管闭塞发生在右冠状动脉占70.0%,回旋支占30.0% ②ST段抬高Ⅲ/Ⅱ〉1,提示右冠状动脉阻塞的敏感性91.4%,特异性86.7% Ⅲ/Ⅱ≤1提示回旋支闭塞的敏感性86.7%,特异性91.4% ③Ⅰ、aVL导联ST段压低预测右冠脉阻塞敏感性71.4%,特异性80.0%,Ⅰ、aVL导联ST段抬高预测回旋支阻塞敏感性80.0%,特异性71.4%.[结论]下壁心肌梗死时心电图对梗死相关动脉有重要的预测价值.

[Objective]To investigate the relationship between the changes of ST segment of electrocardiogram（ECG） and infarct-related artery（IRA） lesion in acute inferior myocardial infarction（IAMI）. [Methods] The change of ST segment in 50 IAMI patients were compared with the result of coronary angiography. [Results]IAMI was caused by right coronary artery（RCA） occlusion in 35 cases（70.0%） and by left circumflex artery（LCX） occlusion in 15 cases（30.0%）. The elevation of ST segment Ⅲ/Ⅱ≤〉1 indicated that the sensitivity and specificity of RCA occlusion was 91.40/00 and 86. 70%, respectively. The elevation of ST segment Ⅲ/Ⅱ≤1 indicated that the sensitivity and specificity of LCX occlusion was 86.7% and 91.4% respectively. The depression of I and aVL-lead ST segment predicted that the sensitivity and specificity of RCA occlusion was 71.4% and 80.0%, respectively. The elevation of I and aVL-lead ST segment predicted that the sensitivity and specificity of LCX occlusion was 80.0% and 71.4%, respectively. [Conclusion] ECG of IAMI has significant value for predicting the infarct-related artery lesion.