急性正后壁心肌梗死10例临床分析

Clinical Analysis of Acute Positive Posterior Wall Myocardial Infarction in 10 Patients

目的 探讨急性正后壁心肌梗死的心电图(ECG)特征。方法 急性正后壁心肌梗死10例病人入院后皆行心电监测3～7天,观察ECG动态变化,同时查心肌酶谱。结果 认为右胸前导联V_1、V_2出现高R波,S-T段下降与T波高耸对称,且排除引起R波增高的其他原因,同时背部导联V_7、V_9出现病理性Q波及QRS综合波、S-T段、T波进行性演变者,综合临床症状和心肌酶谱分析便可诊断。结论 尽管放射性核素心肌显影能显示梗死部位,冠脉造影更是急性正后壁心肌梗死的有力佐证。但ECG检查结合病史和酶谱分析,仍不失其对急性正后壁心肌梗死诊断的重要价值。

Objective To probe into the electrocardiogram Characteristics of acute positive posterior wall myocardial infarction. Methods The patients of acute positive posterior wall myocardial infarction were watched by electrocardiograph for three or seven days after they were hospitalized and at the same time look carefully at the myocardial enzymology. Results The results showed that high R-wave (but excluding other causes of R-wave elevating),decline of S-T segment,and high and symmetric T-wave occurred in V1,V2 leads in patients with actute positive posterior wall myocardial infarction. The sequent changes of QRS complex, S-T segment, T wave, and pathological Q wave in V7, V8,V9 leads were also identified by the cases' analysis. In term of the electrocardiographic features,combining the clinical symptoms, and myocardial enzymology, the diagnosis of acute positive posterior wall myocardial infarction may be made. Conclusion The myocardial development of radioactive nuclein can show the infarction positions the coronary radingrahy is much more forceful evidence in the acute positive posterior wall myocardial infarction, too. But the check ECG combining the clinical symptoms and myocardial emzymology is of great value to the diagnosis of acute positive posterior wall myocardial infarction.