急性下壁心肌梗死心电图表现与冠状动脉造影的对比分析

Comparative Analysis on ECG and Coronary Angiography Findings in Patients with Acute Inferior Wall Myocardial Infarction

目的探讨急性下壁心肌梗死心电图改变与梗死相关动脉的关系.方法对83例急性下壁心肌梗死患者的心电图改变与冠状动脉造影结果进行对比分析.结果心电图ST抬高Ⅲ>Ⅱ,ST下降avL>I时梗死相关动脉大部分为右冠(96.5%,92.6%).7例急性下壁合并右室心梗患者,梗死相关动脉全部为右冠.10例急性下壁心梗合并房室传导阻滞患者,梗死相关动脉全为右冠.15例无ST抬高Ⅲ>Ⅱ及ST下降avL>I的患者梗死相关动脉全为左回旋支.结论急性下壁心肌梗死合并有房室传导阻滞或右室心梗则梗死相关动脉为右冠的可能性大;心电图ST抬高Ⅲ>Ⅱ,ST下降avL>I时梗死相关动脉为右冠的可能性大;心电图无ST抬高Ⅲ>Ⅱ和ST下降avL>I时梗死相关动脉为左回旋支的可能性大.

Objective To discusse the relationship between the ECG changes of acute inferior wall myocardial infarction and infarct arteries. Method We compared the ECG records with the results of coronary angiography of 83 patients with acute inferior wall myocardial infarction. Results Most of the infarct-related arteries were right coronary artery （96.5%, 92.6%） when the ECG showed ST-segment elevation III〉II and ST segment depression avL 〉I. The infarct-related arteries of 7 patients with acute inferior myocardial infarction and right ventricular myocardial infarction were totally right coronary artery. The infarct-related arteries of 10 patients with acute inferior myocardial infarction and atrioventricular block were totally right coronary artery. The infarct-related arteries of 15 patients whose ECG showed no ST-segment elevation III〉II and ST segment depression avL〉I were totally left circumflex artery. Conclusions Most infarct-related arteries of patients with acute inferior wall myocardial infarction and atrioventricular block or right ventricular infarction are right coronary artery. Most infarct-related arteries of patients with ST-segment elevation III 〉II and ST segment depression avL 〉l are right coronary artery. Most infarct-related arteries of patients without ST-segment elevation III 〉II and ST segment depression avL〉I are Left circumflex artery.