当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
29期
26-28
,共3页
急性下壁心肌梗死%心电图%临床应用
急性下壁心肌梗死%心電圖%臨床應用
급성하벽심기경사%심전도%림상응용
Acute inferior wall myocardial infarction%Electrocardiogram%Clinical application
目的：探讨心电图对ST段抬高型急性下壁心肌梗死(IWAMI)的临床应用价值。方法选取2006年2月～2013年3月萍乡市第二人民医院收治的急性下壁心肌梗死(AIMI)患者88例。通过心电图、心肌酶学标志物及冠脉造影检查确诊,均在入院后1～2周内行冠脉造影检查。结果88例急性下壁心肌梗死，Ⅱ、Ⅲ导联ST 段抬高≥1 mm,且STⅢ/STⅡ＞1，右冠脉病变占62.5%，左回旋支病变占37.5%；而下壁AMI ST段抬高Ⅰ＞aVL、Ⅱ＞Ⅲ提示左回旋支闭塞,其中右冠脉病变占71.6%，左回旋支病变占28.4%。88例急性下壁心肌梗死冠脉造影结果：36例单纯单支下壁心肌梗死（40.9%），其中右冠脉病变26例(RCA 72.2%)，左旋支(LCX)病变10例(27.8%)；下壁+正后壁梗死24例((RCA 70.8%)；下壁+右心室梗死20例((RCA 75%)；下壁+前壁梗死8例（LCX 75%）。结论 ST段抬高型急性下壁心肌梗死时体表心电图与冠状动脉闭塞部位明显相关，且梗死部位不同，临床表现也不相同。
目的：探討心電圖對ST段抬高型急性下壁心肌梗死(IWAMI)的臨床應用價值。方法選取2006年2月～2013年3月萍鄉市第二人民醫院收治的急性下壁心肌梗死(AIMI)患者88例。通過心電圖、心肌酶學標誌物及冠脈造影檢查確診,均在入院後1～2週內行冠脈造影檢查。結果88例急性下壁心肌梗死，Ⅱ、Ⅲ導聯ST 段抬高≥1 mm,且STⅢ/STⅡ＞1，右冠脈病變佔62.5%，左迴鏇支病變佔37.5%；而下壁AMI ST段抬高Ⅰ＞aVL、Ⅱ＞Ⅲ提示左迴鏇支閉塞,其中右冠脈病變佔71.6%，左迴鏇支病變佔28.4%。88例急性下壁心肌梗死冠脈造影結果：36例單純單支下壁心肌梗死（40.9%），其中右冠脈病變26例(RCA 72.2%)，左鏇支(LCX)病變10例(27.8%)；下壁+正後壁梗死24例((RCA 70.8%)；下壁+右心室梗死20例((RCA 75%)；下壁+前壁梗死8例（LCX 75%）。結論 ST段抬高型急性下壁心肌梗死時體錶心電圖與冠狀動脈閉塞部位明顯相關，且梗死部位不同，臨床錶現也不相同。
목적：탐토심전도대ST단태고형급성하벽심기경사(IWAMI)적림상응용개치。방법선취2006년2월～2013년3월평향시제이인민의원수치적급성하벽심기경사(AIMI)환자88례。통과심전도、심기매학표지물급관맥조영검사학진,균재입원후1～2주내행관맥조영검사。결과88례급성하벽심기경사，Ⅱ、Ⅲ도련ST 단태고≥1 mm,차STⅢ/STⅡ＞1，우관맥병변점62.5%，좌회선지병변점37.5%；이하벽AMI ST단태고Ⅰ＞aVL、Ⅱ＞Ⅲ제시좌회선지폐새,기중우관맥병변점71.6%，좌회선지병변점28.4%。88례급성하벽심기경사관맥조영결과：36례단순단지하벽심기경사（40.9%），기중우관맥병변26례(RCA 72.2%)，좌선지(LCX)병변10례(27.8%)；하벽+정후벽경사24례((RCA 70.8%)；하벽+우심실경사20례((RCA 75%)；하벽+전벽경사8례（LCX 75%）。결론 ST단태고형급성하벽심기경사시체표심전도여관상동맥폐새부위명현상관，차경사부위불동，림상표현야불상동。
Objective To investigate the clinical value of ECG on ST-segment elevation acute inferior wall myocardial infarction (IWAMI). Methods 88 cases of acute inferior myocardial infarction (AIMI) patients were chosen from February 2006 to March 2013 in the hospital, and diagnosed by electrocardiogram, myocardial enzymes markers as well as coronary angiography (CAG). They were admitted to hospital for coronary angiography after 1-2 weeks. Results 88 cases of acute inferior wall myocardial infarction,Ⅱ,ⅢST-segment elevation≥1 mm, and STⅢ/STⅡ>1,the right coronary artery lesions (62.5%), left circumlfex artery lesions (37.5%);while the inferior wall AMI ST-segment elevationⅠ>aVL,Ⅱ>Ⅲsuggested left circumlfex artery occlusion, which accounted for 71.6%of the right coronary artery lesions, left circumlfex artery lesions accounted for 28.4%. 88 cases of acute inferior wall myocardial infarction undergoing coronary angiography:36 cases of simple single inferior wall myocardial infarction (40.9%), 26 patients of which were right coronary artery (RCA 72.2%), 10 cases of left circumlfex artery lesions (LCX 27.8%);inferior wall added posterior wall infarction in 24 cases (RCA 70.8%);inferior wall infarction added right ventricular in 20 cases (RCA 75%);inferior wall infarction added anterior wall infarction 8 cases (LCX 75%). Conclusion ECG was signiifcantly correlated with coronary occlusion in ST segment elevation acute inferior wall myocardial infarction. Cinical manifestations are identical with infarcted size.
