判断急性下壁心肌梗死冠状动脉堵塞位置心电图新标准的探讨

A new electrocardiographic criteria for the identification of the culprit vessel in inferior wall myocardial infarction

目的 :评价判断急性下壁心肌梗死 (AIMI)梗死相关血管的心电图新标准。方法 :将 1999年 11月～ 2 0 0 1年 8月我科收治的 76例AIMI患者 ,依V3 导联ST段压低与Ⅲ导联ST段抬高的比值 (STV3 /Ⅲ )分为 3组 :V3 /Ⅲ <0 .5 ,V3 /Ⅲ≥ 0 .5～≤ 1.2 ,V3 /Ⅲ >1.2。通过冠状动脉造影 (CAG)观察三组患者梗死相关血管是右冠状动脉 (RCA)近段、RCA远段还是左回旋支 (LCX)。结果 :V3 /Ⅲ <0 .5组梗死相关血管是RCA近段 ,V3 /Ⅲ≥0 .5～≤ 1.2组梗死相关血管是RCA远段 ,V3 /Ⅲ >1.2组梗死相关血管是LCX。结论 :STV3 /Ⅲ是判断AIMI冠状动脉堵塞位置较好标准 。

Objective:To evaluate the new electrocardiographic criteria for the identification of the culprit vessel in acute inferior wall myocardial infarction(AIMI).Methods:We divided the 76 AIMI patients into 3 groups according to the ratio of lead V3 ST segment depression and lead Ⅲ ST segment elevation(ST V 3/Ⅲ): V 3/Ⅲ< 0.5 ,V 3/Ⅲ≥ 0.5 ～≤ 1.2 ,V 3/Ⅲ> 1.2 and found the relationship between ST V 3/Ⅲ and the culprit vessel.Results:The culprit vessels of AIMI of the 3 groups is proximal RCA, distal RCA and LCX ,respectively.Conclusion:ST V 3/Ⅲ is a good criteria for identification of the culprit vessel in AIMI and it can identify the occlusion of proximal and distal RCA also.