心电图在急性下壁心肌梗死相关动脉中的预测价值

Predictive value of electrocardiogram in acute inferior wall myocardial infarction related artery

目的探讨心电图在急性下壁心肌梗死相关动脉中的预测价值。方法选取2010年2月～2012年2月西安市第五医院收治的80例初步诊断为急性下壁性心肌梗死患者,根据患者的梗死相关动脉分为左回旋支动脉组18例和右冠状动脉组62例,两组患者均给予心电图检查。比较两组患者心电图改变与梗死相关动脉的关系及心电图各指标的灵敏度和特异度。结果严重慢性心律失常、合并右室梗死、ST V1压低、ST V2压低、STⅠ压低≥0.5 mm、STⅠ抬高≥0.5 mm、STⅢ抬高≥STⅡ、STaVL压低≥0.5 mm、ST aVL抬高≥0.5 mm、ST V1抬高≥0.5 mm、ST V2+aVF>0在右冠状动脉组发生率高于左回旋支动脉组,差异有统计学意义(P<0.05);而V3/Ⅲ≤1.2在两组间差异无统计学意义(P>0.05)。在右冠状动脉组中,合并右室梗死、ST V1抬高≥0.5 mm、STⅠ压低≥0.5 mm的阳性预测值和特异度均为100.0%;STⅢ抬高≥STⅡ的灵敏度最高;ST aVL压低≥0.5 mm的阴性预测值最高。在左回旋支动脉组中,ST aVL抬高≥0.5 mm的阳性预测值和特异度均为100.0%;STⅠ抬高≥0.5 mm的灵敏度最高;STⅠ抬高≥0.5 mm、STⅢ抬高≤STⅡ的阴性预测值为最高。结论急性下壁心肌梗死以右冠状动脉为主要的梗死相关动脉,不同梗死相关动脉在心电图的表现上存在一定的差异。心电图在急性下壁心肌梗死相关动脉预测中有重要的价值。

Objective To explore the predictive value of electrocardiogram （ECG） in acute inferior wall myocardial infarction related artery. Methods 80 cases of primary diagnosis for patients with acute inferior wall myocardial infarction were selected in the Fifth Hospital of Xi＇an City from February 2010 to February 2012, they were divided into left circumflex branch group in 18 cases and right coronary artery group in 62 cases according to patients＂ artery infarction related artery, two groups of patients were given ECG examination. Two groups of patients with ECG changes and relationship of infarction related artery and ECG and the sensitivity of various indicators specific degrees were compared. Results The severe chronic arrhythmia, with right ventricular infarction, ST1 down up ≥ 0.5 ram, ST I down up ≥0.5 mm, STz raised ≥ STⅡ, STaVL. down up ≥ 0.5 ram, STavE raised ≥ 0.5 ram, STw raised t〉 0.5 ram, STv2＋aVF≥ 0 in right coronary artery group was higher than that of left circumflex branch artery group, the difference was statistically significant （P 〈 0.05）; The V3/Ⅲ ≤ 1.2 difference between the two groups had no statistical significance （P 〉 0.05）. In the right coronary artery group, the positive predictive value and specific degrees of right ventricular infarction merger, STw raised ≥ 0.5 mm , ST1 down up ≥ 0.5 mm was 100.0%; the sensitivity of STⅢ raised ≥ST H was the highest; the negative predictive value of ST,vL down up ≥0.5 mm was the highest. In left circumflex artery group, positive predictive value and specific degrees of STavE down up ≥ 0.5 mm was 100.0%; the sensitivity of ST1 raised ≥ 0.5 ram; the negative predictive value of ST1 raised ≥ 0.5 mm and STm raised ≥ STH. Conclusion The acute inferior wall myocardial infarction, primarily in the right coronary artery infarction related artery, the expression of infarction related artery on the electrocardiogram there exist certain differences. Electrocardiogram in acute inferior wall myocardial infarction related artery prediction has important value.