V_(1～3)导联心电图改变对急性后壁心肌梗死的诊断价值

Diagnostic value of changes in leads V 1～3 at posterior wall acute myocardial infarction

目的 :探讨 V1～ 3导联心电图对急性后壁心肌梗死 (PAMI)的诊断价值。方法 :对 2 8例 PAMI V1～ 3导联进行观察分析 ,并与 70例正常人作对照。结果 :PAMI时 ,V1 导联 r/ s≥ 1、r波时限≥ 0 .0 4s的特异性分别达98.6 %与 95 .7% ,高于 V2 导联 ;V2 导联两项指标敏感性为 82 .1%、92 .9% ,高于 V1 导联。V1～ 3导联 ST段压低敏感性 (32 .1% )低 ,但特异性 (10 0 % )高。V1～ 3不仅表现 T波高耸 ,且 Tv2 >Tv1 ,3更为多见。结论 :V1～ 2 导联 r/ s≥ 1、r波时限≥ 0 .0 4s、V1～ 3导联 ST段压低、Tv2 >Tv1 ,3对 PAMI有重要诊断价值 ,作为常规导联 。

Objective:To explore diagnostic value of changes in leads V 1～3 at posterior wall acute myocardial infarction(PAMI).Method:ECG in leads V 1～3 of 28 cases PAMI patients were analised and compared with 70 normal controls.Result:Specificity of r/s≥1,r≥ 0.04 s in leads V 1(98.6%, 95.7 %) was higher than that in lead V 2 after PAMI,but sensitivity in lead V 2 ( 82.1 %, 92.9 %) higher than that in lead V 1;T waves in leads V 1～3 were not only upright but also Tv 2 >Tv 1,3 more frequently.Conclusion:ECG in leads V 1～2 with r/s≥1,r≥ 0.04 s and in leads V 1～3 with ST segment depression,Tv 2 >Tv 1,3 are important diagnostic clues for PAMI.It has special clinical significance because of routine leads to be used.