R波递增不良对前壁急性心肌梗死的诊断价值

Diagnostic value of poor R-wave progression in patients with anterior acute myocardial infarction

目的探讨12导联心电图（ECG）胸导联R波递增不良（PRWP）对前壁急性心肌梗死（acute myocardial infarction,AMI）的诊断价值。方法选取2012-01-2015-05该院收治的胸痛伴PRWP并行冠状动脉造影检查的患者48例,根据PRWP是否有动态变化分为有变化组23例（A组）和无变化组25例（B组）,统计分析两组患者的临床表现、实验室检查、12导联ECG、心脏肌钙蛋白I（c TNI）水平、超声心动图和冠状动脉造影（CAG）等资料,比较两组患者前壁AMI的阳性预测值。结果 A组对前壁AMI的阳性预测值为34.78%,B组的阳性预测值为20.00%,两组比较差异有统计学意义（P〈0.05）。结论动态变化的PRWP对诊断前壁AMI仍有一定临床应用价值。

Objective To investigate the diagnostic value of poor R-wave progression （ PRWP） in patientswith anterior acute myocardial infarction（ AMI）. Methods Forty-eight patients witli chest pain and PRWP were recruited in this study. According to the 12-lead electrocardiogram（ ECG） , 23 patients with the dynamic changes of PRWP were collected as group A , and the other 25 patients without the dynamic changes of PRWP as group B. The clinical characteristics, laboratory examination, 12-lead ECG, cardiac troponin I （ cTNI） , ultrasonic cardiogram（ UCG） and coronary angiography（ CAG） were analyzed in the two groups, and their positive predictive terior AMI were compared. Results The positive predictive value in the diagnosis of anterior AMI wgroup A , and 20. 00b in group B , P 〈0. 05. Conclusion The dynamic changes of PRWP are still annostic clue for anterior AMI patients.