CAJ | 학술논문

为验证心电图aVL导联QRS波群变化能否作为下壁急性心肌梗死（AMI）罪犯血管的判定标准，比较60例下壁AMI患者aVL导联QRS波群变化与冠状动脉造影结果的相关性，分析aVL导联QRS波群两种模式（Ⅰ型：S/R ≤1/3，ST段抬高≤1 mm；Ⅱ型：S/R>1/3，ST段抬高>1 mm）对判断下壁AMI罪犯血管的临床价值。结果：aVL导联的Ⅰ型QRS波群改变在左冠状动脉回旋支闭塞（LCX）组出现率为89%，右冠状动脉闭塞组为24%（P<0.001）。Ⅱ型改变在LCX组出现率为11%、RCA组为76%（P<0.001）。Ⅰ 型心电图变化预测LCX闭塞的敏感度为89%、特异性为76%。Ⅱ型心电图改变预测RCA闭塞的敏感度为76%、特异性为89%。结论：aVL导联的Ⅰ型QRS波群变化是判断LCX型AMI敏感、特异的预测指标，而Ⅱ型QRS波群变化是RCA型AMI有效的预测指标。
위험증심전도aVL도련QRS파군변화능부작위하벽급 성심기경사（AMI）죄범혈관적판정표준，비교60례하벽AMI환자aVL도련QRS파군변화여관상 동맥조영결과적상관성，분석aVL도련QRS파군량충모식（Ⅰ형：S/R ≤1/3，ST단태고≤1 mm；Ⅱ형：S/R>1/3，ST단태고>1 mm）대판단하벽AMI죄범혈관적림상개치。 결과：aVL도 련적Ⅰ형QRS파군개변재좌관상동맥회선지폐새（LCX）조출현솔위89%，우관상동맥폐새조 위24%（P<0.001）。Ⅱ형개변재LCX조출현솔위11%、RCA조위76%（P<0.001）。Ⅰ 형심전도변화예측LCX폐새적민감도위89%、특이성위76%。Ⅱ형심전도개변예측RCA폐새적민 감도위76%、특이성위89%。결론：aVL도련적Ⅰ형QRS파군변화시판단LCX형AMI민감、특이적 예측지표，이Ⅱ형QRS파군변화시RCA형AMI유효적예측지표。
To test and verify if the culprit artery in inferior wall acute myoca rdial infarction(AMI) can be predicted by the configuration of the QRS complex In lead aVL,the relation between the configuration of the QRS complex in lead aV Land the results of coronary angiography was studied in 60 inferior wall AMI patient,the values of the two pattern (pattern Ⅰ:S/R wave ratio≤1/3，ST elevatio n ≤1 mm；pattern Ⅱ：S/R wave ratio >1/3，ST elevation>1 mm)in predicting the c ulprit artery of inferior wall AMI patient were investigated.Results:Pattern Ⅰ of QRS complex in lead aVL was found in 89% of the left circumflex (LCX) group compared with 24% of the right coronary artery(RCA) group（P<0.001）.Pattern Ⅱ was found in only 11% of the LCX group compared with 76% of the RCA group（ P<0.001）.Pattern Ⅰhad a sensitivity of 89% and specificity of 76% to pred ict LCX related AMI.Pattern Ⅱhad a sensitivity of 76% and specificity of 89% t o predict RCA related AMI.Conclusions: Pattern Ⅰ of QRS complex in lead aVL is a sensitive and specific marker for LCX artery AMI,whereas pattern Ⅱ is suggest ive of RCA-related AMI disease.