急性前壁心肌梗死合并下壁导联ST段下移的临床意义

Clinical significance of inferior ST segment depression during acute anterior myocardial infarction

48例首次急性前壁心肌梗死患者中伴下壁导联ST段平均下移>1mm、持续时间>48h者,CK和CK-MB的平均峰值更高,核素检查左室射血分数<40％,左室下壁运动障碍、出现放射性稀疏或缺损区的发生率也更高(P<0.05或<0.01)。说明这类病人有下壁心肌缺血,且可能心肌坏死面积更广。

In 48 patients with first time acute myocardial infarction of anterior wall accompanied by ST depression > 1mm and maintained longer than 48 hours on leads representing inferior wall, it was shown that the average peak values of CK and CK-MB significantly increased. Also, by radionuclide testing, the incidences of decreased uptake of radioactive substance or defect areas, the LVEF<40% and the motion abnormality of left ventricular inferior wall were highly elevated. These changes might indicate the presences of ischemia of inferior wall and damage of wider area of myocardium.