急性下壁心肌梗死心电图与冠状动脉造影的对比分析

Analysis of electrocardiographic characteristics and coronary artery angiography image in patients with acute inferior myocardial infarction

为分析右冠状动脉 (RCA)或左回旋支 (LCX)急性下壁心肌梗死 (AMI)时的心电图特征 ,选择 5 5例患者进行常规 1 8导联心电图及选择性冠状动脉造影检查。结果显示发生房室传导阻滞组的RCA病变率明显高于无房室传导阻滞组 (1 0 0 %vs 70 .97% ,P <0 .0 1 ) ;STⅢ ↑ /STⅡ ↑ >1组的RCA病变率明显高于STⅢ ↑ /STⅡ ↑≤ 1组 (1 0 0 %vs 4 7.6 8% ,P <0 .0 1 ) ;STⅠ ↓ +STaVL↓组的RCA病变率明显高于非STⅠ ↓ +STaVL↓组 (90 .91 %vs 6 6 .6 7% ,P <0 .0 5 ) ;V4RST↑组的RCA病变率明显高于无V4RST↑组 (1 0 0 %vs 75 % ,P <0 .0 5 )。研究认为急性下壁心肌梗死时发生房室传导阻滞、STⅢ ↑ /STⅡ ↑ >1、STⅠ ↓ +STaVL↓和V4RST↑有助于RCA病变的临床诊断。

This paper is to find the electrocardiographic characteristics for predicting the right coronary artery (RCA) and left circumflex artery(LCX) acute myocardiac infarction(AMI).Fifty five patients with acute inferior myocardial infarction received electrocardiography(ECG) and coronary artery angiography(CAG) examination. The results suggested that the prevalence of RCA lesion in atriventricular block(AVB) group was higher than that in non AVB group(100% vs 70.97%, P < 0.01); that in ST Ⅲ ↑/ST Ⅱ ↑>1 group was higher than in ST Ⅲ ↑/ST Ⅱ ↑≤1 group (100% vs 47.68%, P <0.01);that in ST Ⅰ↓+ST aVL ↓ group was higher than in non ST Ⅰ↓+ST aVL ↓group (90.91% vs 66.67%, P <0.05);and that in V 4R ST↑group were higher than in non V 4R ST↑group(100% vs 75%, P <0.05).The research showed that atriventricular block,ST Ⅲ ↑/ST Ⅱ ↑>1,ST Ⅰ↓+ST aVL ↓ and V 4R ST↑could help the clinical diagnosis of RCA lesion in pateints with acute inferior myocardial infarction.