中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
21期
3271-3273
,共3页
心肌梗死%心电描记术%下壁导联ST段改变%临床特点
心肌梗死%心電描記術%下壁導聯ST段改變%臨床特點
심기경사%심전묘기술%하벽도련ST단개변%림상특점
Myocardial infarction%Electrocardiography%Inferior ST segment changes%Clinical characteristics
目的 探讨急性下壁心肌梗死(IAMI)伴不同下壁导联ST段改变的临床特点.方法 前瞻性分析2010年1月至2012年2月住院接受治疗的64例急性前壁心肌梗死患者的临床资料,将其按照入选时的心电图下壁导联ST段改变情况将其分为三组,其中A组(16例)下壁(Ⅱ、Ⅲ、aVF)中至少两个导联ST段抬高≥0.1 mV;B组(26例)下壁(Ⅱ、Ⅲ、aVF)中至少两个导联ST段压低；C组(22例)下壁(Ⅱ、Ⅲ、aVF)中仅一个导联或均无ST段改变；探讨急性前壁心梗伴不同下壁导联ST-T改变的梗死相关血管(IRCA)及梗死面积和心功能.结果 A、B、C三组IRCA均判断一致.对三组IRCA情况进行比较发现A组患者中以“绕过心尖的LAD”中远段为主,占81.25％；而B组26例患者均为非“绕过心尖的LAD”,其中非“绕过心尖的LAD”中近段18例,非“绕过心尖的LAD”中远段8例；C组22例患者中21为非“绕过心尖的LAD”,1例为“绕过心尖的LAD”中远段.A、B、C三组IRCA情况差异具有统计学意义(F=6.32、5.92、7.08、4.11,均P＜0.05).结论 IRCA为LAD的急性前壁心梗时下壁ST段改变可能与LAD长度和病变部位有关,前壁AMI时下壁ST段的变化可以预测IRCA位置和LAD形态；与大多数的研究相一致.前壁合并下壁ST段同时抬高的患者若IRCA为“绕过心尖的LAD”,其梗死面积较小,心功能较好.
目的 探討急性下壁心肌梗死(IAMI)伴不同下壁導聯ST段改變的臨床特點.方法 前瞻性分析2010年1月至2012年2月住院接受治療的64例急性前壁心肌梗死患者的臨床資料,將其按照入選時的心電圖下壁導聯ST段改變情況將其分為三組,其中A組(16例)下壁(Ⅱ、Ⅲ、aVF)中至少兩箇導聯ST段抬高≥0.1 mV;B組(26例)下壁(Ⅱ、Ⅲ、aVF)中至少兩箇導聯ST段壓低；C組(22例)下壁(Ⅱ、Ⅲ、aVF)中僅一箇導聯或均無ST段改變；探討急性前壁心梗伴不同下壁導聯ST-T改變的梗死相關血管(IRCA)及梗死麵積和心功能.結果 A、B、C三組IRCA均判斷一緻.對三組IRCA情況進行比較髮現A組患者中以“繞過心尖的LAD”中遠段為主,佔81.25％；而B組26例患者均為非“繞過心尖的LAD”,其中非“繞過心尖的LAD”中近段18例,非“繞過心尖的LAD”中遠段8例；C組22例患者中21為非“繞過心尖的LAD”,1例為“繞過心尖的LAD”中遠段.A、B、C三組IRCA情況差異具有統計學意義(F=6.32、5.92、7.08、4.11,均P＜0.05).結論 IRCA為LAD的急性前壁心梗時下壁ST段改變可能與LAD長度和病變部位有關,前壁AMI時下壁ST段的變化可以預測IRCA位置和LAD形態；與大多數的研究相一緻.前壁閤併下壁ST段同時抬高的患者若IRCA為“繞過心尖的LAD”,其梗死麵積較小,心功能較好.
목적 탐토급성하벽심기경사(IAMI)반불동하벽도련ST단개변적림상특점.방법 전첨성분석2010년1월지2012년2월주원접수치료적64례급성전벽심기경사환자적림상자료,장기안조입선시적심전도하벽도련ST단개변정황장기분위삼조,기중A조(16례)하벽(Ⅱ、Ⅲ、aVF)중지소량개도련ST단태고≥0.1 mV;B조(26례)하벽(Ⅱ、Ⅲ、aVF)중지소량개도련ST단압저；C조(22례)하벽(Ⅱ、Ⅲ、aVF)중부일개도련혹균무ST단개변；탐토급성전벽심경반불동하벽도련ST-T개변적경사상관혈관(IRCA)급경사면적화심공능.결과 A、B、C삼조IRCA균판단일치.대삼조IRCA정황진행비교발현A조환자중이“요과심첨적LAD”중원단위주,점81.25％；이B조26례환자균위비“요과심첨적LAD”,기중비“요과심첨적LAD”중근단18례,비“요과심첨적LAD”중원단8례；C조22례환자중21위비“요과심첨적LAD”,1례위“요과심첨적LAD”중원단.A、B、C삼조IRCA정황차이구유통계학의의(F=6.32、5.92、7.08、4.11,균P＜0.05).결론 IRCA위LAD적급성전벽심경시하벽ST단개변가능여LAD장도화병변부위유관,전벽AMI시하벽ST단적변화가이예측IRCA위치화LAD형태；여대다수적연구상일치.전벽합병하벽ST단동시태고적환자약IRCA위“요과심첨적LAD”,기경사면적교소,심공능교호.
Objective To investigate the clinical characteristics of inferior acute myocardial infarction (IAMI) with different inferior ST segment change.Methods The clinical data of 64 cases with acute anterior wall myocardial infarction from January 2010 to February 2012 in the hospital were prospectivly analyzed.According to wall leads ECG ST segment in the change situation,they were divided into three groups,group A (16 cases),under the wall (]Ⅱ,Ⅲ,aVF) of at least two lead ST segment elevation ≥0.1mV,group B(26 cases) under the wall(Ⅱ,Ⅲ,aVF) of at least two lead ST segment depression,group C (22 cases) under the wall(Ⅱ,Ⅲ,aVF) only a lead or no ST segment change.The infarct related artery,acute anterior wall myocardial infarction with different inferior ST-T change (infarction related coronary artery,IRCA),the infarct size and heart function were studied.Results IRCA in the three groups was consistent.The comparison of IRCA among the three groups showed that,A group of patients with “around the apical LAD” COSCO segment,accounting for 81.25％,and 26 cases in B group were not “around the apical LAD”,which was not “around the apical LAD” in 18 cases,8 cases of non-“ around the apex” COSCO LAD,of 22 patients in C group,21 cases non-“ around the apical LAD”,1 case was “around the apical LAD” COSCO,and the difference was statistically significant(F =6.32,5.92,7.08,4.11,all P ＜ 0.05).Conclusion IRCA is the LAD of acute anterior wall myocardial infarction of inferior ST segment changes may be related with the length of LAD and the lesion site,changes of inferior ST segment of anterior wall AMI can predict the IRCA position and LAD morphology,consistent with most studies.Patients with anterior wall and inferior wall ST segment elevation if IRCA is “around the apical LAD”,the infarction area is smaller,better heart function.
