急性下壁心肌梗死心前导联ST段压低的临床意义

Clinical Implication of Precordial ST Segment Depression in Acute Inferior Myocardial Infarction

目的 评价急性下壁心肌梗死伴心前导联 ST段压低的临床意义。方法 36例急性下壁心肌梗死患者早期心电图与入院后 2～ 3周冠脉造影对照 ,观察急性下壁心肌梗死伴心前导联 ST段压低与右冠脉病变、多支血管病变关系。结果 急性下壁心肌梗死病变血管多涉及右冠状动脉 ,伴心前导联 ST段压低者有 1 4例 ( 70 % ) ,心前导联 ST段正常者有 1 2例 ( 75% )。且伴心前导联 ST段压低者较心前导联 ST段正常者病变血管大部分为多支病变 ( 6 5% V2 5% )。结论 急性下壁心肌梗死合并心前导联 ST段压低 ,表示多支冠脉病变或梗死面积大 ,应给予积极治疗 ,以改善患者病程和预后。

Objective To evaluate the clinical value of precordial ST segment depression in acute inferior myocardial(AIMI).Methods ECG on admission of 36 AIMI patients and their selected coronary angiography(SCA) performed after 2～3 weeks were analyzed, in order to identify the interrelationship between precordial ST segment depression in AIMI and right coronary artery(RCA) lesions,multivessel lesions.Results Diseased vessels in AIMI involved mostly with RCA.Precordial ST segment depression was noted in 14 involved mostly with RCA. Precordial ST segment depression was noted in 14 cases(70%),and normal precordial ST segment was noted in 14 cases(75%), Multivessel lesions in AIMI patients with precordial ST segment depression were more than that with precordial ST segment normal(65% V 25%).Conclusion Precordial ST segment depression in AIMI is associated with multivessel lesions or larger infarction area. Active treatment should be adopted.