CAJ | 학술논문

目的分析研究急性下壁心肌梗死患者的临床特点. 方法将急性下壁心肌梗死患者100例根据冠状动脉造影结果分为两组:76例为右冠状动脉(RCA)闭塞(A组),24例为左回旋支冠状动脉(LCX)闭塞(B组). 结果心电图ST段抬高STⅢ>STⅡ及ST段压低STAVL>ST I A组显著高于B组(均P<0.05);ST段抬高STⅢ<STII A组显著低于B组(P<0.01);ST段抬高STV4R>0.1 mV A组显著高于B组(P<0.05);胸前导联V1～6ST段压低患者中,合并左前降支冠状动脉(LAD)病变的患者显著高于胸前导联V1～6ST段无压低者(P<0.05);左心室射血分数(LVEF)A组[(51±14)%]显著低于B组[(57±10)%](P<0.05);合并右心室心肌梗死A组显著高于B组(P<0.05);急性下壁心肌梗死患者总的住院病死率6%,均为A组,但心源性休克、心力衰竭、Ⅱ、Ⅲ度房室传导阻滞,室性心动过速/心室颤动及住院病死率,两组差异均无统计学意义(均P>0.05);死亡者中心源性休克占83.3%. 结论心电图Ⅲ、Ⅱ、I、AVL、及V4R导联ST段变化能预测急性下壁心肌梗死相关血管,急性下壁心肌梗死患者伴胸前导联ST段压低提示LAD病变,RCA闭塞所致下壁心肌梗死LVEF低于LCX闭塞者,心源性休克为死亡主要原因.
목적 분석연구급성하벽심기경사환자적림상특점. 방법 장급성하벽심기경사환자100례근거관상동맥조영결과분위량조:76례위우관상동맥(RCA)폐새(A조),24례위좌회선지관상동맥(LCX)폐새(B조). 결과 심전도ST단태고STⅢ>STⅡ급ST단압저STAVL>ST I A조현저고우B조(균P<0.05);ST단태고STⅢ<STII A조현저저우B조(P<0.01);ST단태고STV4R>0.1 mV A조현저고우B조(P<0.05);흉전도련V1～6ST단압저환자중,합병좌전강지관상동맥(LAD)병변적환자현저고우흉전도련V1～6ST단무압저자(P<0.05);좌심실사혈분수(LVEF)A조[(51±14)%]현저저우B조[(57±10)%](P<0.05);합병우심실심기경사A조현저고우B조(P<0.05);급성하벽심기경사환자총적주원병사솔6%,균위A조,단심원성휴극、심력쇠갈、Ⅱ、Ⅲ도방실전도조체,실성심동과속/심실전동급주원병사솔,량조차이균무통계학의의(균P>0.05);사망자중심원성휴극점83.3%. 결론 심전도Ⅲ、Ⅱ、I、AVL、급V4R도련ST단변화능예측급성하벽심기경사상관혈관,급성하벽심기경사환자반흉전도련ST단압저제시LAD병변,RCA폐새소치하벽심기경사LVEF저우LCX폐새자,심원성휴극위사망주요원인.
Objecfive To study the clinical characteristics of acute inferior myocardial infarction.Methods 100 patients with acute inferior infarction were divided into 2 groups according to coronary angiography:group A (n=76) with right coronary artery occlusion;group B(n=24) with left circumflex artery occlusion.Results The frequencies of Electrocardiogram(ECG) ST segment elevation ST Ⅲ>ST Ⅱ and ST segment depression STAVL>STI in group A was significantly higher than that in group B(P<0.05);The frequency of ECG ST segment elevation STⅢ<STⅡ in group A wag significantly lower than that in group B(P<0.01);The frequency of ECG STV4R elevation >O.1 mV in group A was significantly higher than that in group B(P<0.05);The number of ECG with precor-dial lcads V1～6 ST segment depression >0.1 mv with lesion of left anterior descending coronary was more significant than that without precordial Vl-6 leads ST segment depression (P<0.05).Left ventricular ejection fraction (LVEF)(51%±14%) in group A was significant lower than that in group B(57%±10%)(P<0.05);The patients in group A with right ventricular infarction were more significant than those in group B(P<0.05);The total hospital mortality of patients with acute inferior myocardial infarction was 6%,and they were all in group A.But there was no significance between the two groups about cardiogenic shock,heart failure,Ⅱ degree and Ⅲ degree atrial ventricular b1ock,ventrieular tachycardia/ventrieular fibrillation and the hospital mortality.The mortality with cardiogenic shock was 83.3%.Conclusion The changes of ECG ST segment in Ⅲ,Ⅱ,Ⅰ,AVL and V4R leads can predict relatedinfarct coronary artery with acute inferior myocardial infarction.The patients with precordial Vl～6 leads ST segment depression indicates lesion of LAD.The LVEF of patients with RCA occlusion is lower than that with LCX occlusion. The primary cause of death is eardiogenic shock.