急性下壁心肌梗死时心电图对分析心肌梗死相关动脉和闭塞位置的作用

马永娴

（陕西省宝鸡高新人民医院，陕西 宝鸡，721000）

浏览次数：131次 下载次数：327次

摘要：

目的 探讨急性下壁心肌梗死（AIMI）时心电图对分析心肌梗死相关动脉和闭塞位置的作用。方法 纳入在我院治疗并 行冠脉造影的AIMI 患者90 例，分为A 组（右冠状动脉近段梗死）、B 组（右冠状动脉远段梗死）、C 组（左回旋支梗死），各30 例。分析心电图对判断心肌梗死相关动脉和闭塞位置的作用。结果 A、B、C 三组导联STV3引值依次升高，STⅢ尹值依次降低，差异显著（P<0.05）；A 组患者STV3/STⅢ<0.5 占比最大，为70.00%；B 组0.5≤STV3/STⅢ≤1.2 占比最大，为63.33%；C 组 STV3/STⅢ>1.2 占比最大，为63.33%，组间比较，差异显著（P<0.05）。STV3/STⅢ<0.5、0.5≤STV3/STⅢ≤1.2 及STV3/STⅢ>1.2 时，组间比较，A、B、C 组的灵敏度、特异度、阳性、阴性预测值分别最高（P<0.05）。结论 心电图STV3/ST芋是判断心肌梗死相 关动脉和闭塞位置的有效指标。

关键词：急性下壁心肌梗死；心电图；闭塞位置

中图分类号：R542.22文献标志码：A文章编号：2096-1413(2018)03-0103-02

Effect of ECG on analysis of related artery and blocking position in acute inferior myocardial infarction
MA Yong-xian
(Gaoxin People``s Hospital of Baoji, Baoji 721000, China)

ABSTRACT: Objective To discuss the effect of ECG on analysis of related artery and blocking position in acute inferior myocardial infarction (AIMI). Methods Ninety cases of patients with AIMI who underwent coronary angiography in our hospital were enrolled in this study, and were divided into group A (proximal segment of right coronary infarction), group B (distal segment of right coronary infarction) and group C (left circumflex artery infarction), with 30 cases in each group. The effect of ECG on analysis of related artery and blocking position of AIMI was analyzed. Results STV3引 in groups A, B and C increased in turn, STⅢ decreased in turn (P<0.05). STV3/STⅢ<0.5 accounted for the largest proportion in group A, which was 70.00%; 0.5≤STV3/STⅢ≤1.2 accounted for the largest proportion in group B, which was 63.33%; STV3/STⅢ> 1.2 accounted for the largest proportion in group C, which was 63.33%, the differences were significant (P<0.05). InSTV3/STⅢ<0.5, 0.5≤STV3/STⅢ≤1.2 and STV3/STⅢ>1.2, the sensitivity, specificity, positive and negative predictive values were the highest in groups A, B and C respectively (P<0.05). Conclusion ECG STV3/STⅢ is the effective indicator to determine related artery and blocking position of AIMI.
KEYWORDS: acute inferior myocardial infarction (AIMI); ECG; blocking position

参考文献：
[1] 黄琴耿,苏倬杰,郑建裕.急性下壁心肌梗死患者心电图ST 段抬高形态对预后的判断价值研究[J].临床急诊杂志,2016,17(5):347-349.
[2] 王江洪,胡晓军,孙跃玲,等.心电图"镜面"导联ST 段改变对前壁心肌梗死相关血管的判定价值[J].临床急诊杂志,2015,16(3):172-175.
[3] 仇苓苓,陈晓敏,王春靓.急性前壁心肌梗死时体表心电图初步预测前降支闭塞部位[J].重庆医学,2015,44(1):66-67.
[4] 李俊秋,刘丽云,王春玲,等.右冠状动脉为梗死相关血管的急性下壁心肌梗死的心电图特征[J].中国病案,2015,16(11):87-91.
[5] 梅志亮,章志玲,周淑兰.心电图在右冠病变所致急性下壁心肌梗死时的预测价值[J].中国循证心血管医学杂志,2015,8(2):251-252.
[6] 许志茹.急性前壁和前壁合并下壁心肌梗死患者入院时心电图与冠状动脉血管造影所示病变之间的关系及预测价值[J].临床和实验医学杂志,2015,14(7):556-558.
[7] 王江洪,胡晓军,孙跃玲,等.心电图对急性下壁心肌梗死合并冠状动脉多支病变的判定价值[J].中国介入心脏病学杂志,2015,23(6):333-337.