CAJ | 학술논문

目的：通过与冠状动脉造影(CAG)结果比较，分析急性下壁心肌梗死患者的体表心电图(ECG)改变的特点，总结体表心电图在定位急性下壁心肌梗死(IAMI)患者梗死相关动脉(IRA)中的作用。方法：收治急性下壁心肌梗死明确诊断为单支冠状动脉闭塞患者93例，对其进行回顾性研究，梗死相关动脉为右冠状动脉(RCA)65例，左回旋支(LCX)28例。分析比较梗死相关动脉开通前心电图改变。结果：①STⅢ↑＞STⅡ↑预测RCA闭塞的敏感性89.2%，特异性85.7%，阳性预测值93.5%，阴性预测值77.4%。②STV3↓/STⅢ↑≤1.2预测 RCA 闭塞的敏感性78.5%，特异性57.1%，阳性预测值80.9%，阴性预测值53.3%。③STaVL↓＞STⅠ↓预测RCA闭塞的敏感性70.8%，特异性78.6%，阳性预测值88.5%，阴性预测值53.7%。④STⅠ↓预测RCA闭塞的敏感性70.8%，特异性89.3%，阳性预测值93.9%，阴性预测值56.8%。⑤STV4R↑预测RCA闭塞的敏感性41.5%，特异性100%，阳性预测值100%，阴性预测值42.4%。⑥STⅠ等电位线预测 LCX 闭塞的敏感性78.6%，特异性70.8%，阳性预测值53.7%，阴性预测值88.5%。⑦STⅢ↑＜STⅡ↑预测LCX闭塞的敏感性71.4%，特异性92.3%，阳性预测值80%，阴性预测值88.2%。⑧STV3↓/STⅢ↑＞1.2预测LCX闭塞的敏感性57.1%，特异性78.5%，阳性预测值53.3%，阴性预测值80.9%。⑨STⅠ↑预测LCX闭塞的敏感性10.7%，特异性100%，阳性预测值100%，阴性预测值72.2%。结论：心电图Ⅰ、Ⅱ、Ⅲ、aVL导联及V3导联、V4R导联ST段改变能预测急性下壁心肌梗死患者梗死相关血管。
목적：통과여관상동맥조영(CAG)결과비교，분석급성하벽심기경사환자적체표심전도(ECG)개변적특점，총결체표심전도재정위급성하벽심기경사(IAMI)환자경사상관동맥(IRA)중적작용。방법：수치급성하벽심기경사명학진단위단지관상동맥폐새환자93례，대기진행회고성연구，경사상관동맥위우관상동맥(RCA)65례，좌회선지(LCX)28례。분석비교경사상관동맥개통전심전도개변。결과：①STⅢ↑＞STⅡ↑예측RCA폐새적민감성89.2%，특이성85.7%，양성예측치93.5%，음성예측치77.4%。②STV3↓/STⅢ↑≤1.2예측 RCA 폐새적민감성78.5%，특이성57.1%，양성예측치80.9%，음성예측치53.3%。③STaVL↓＞STⅠ↓예측RCA폐새적민감성70.8%，특이성78.6%，양성예측치88.5%，음성예측치53.7%。④STⅠ↓예측RCA폐새적민감성70.8%，특이성89.3%，양성예측치93.9%，음성예측치56.8%。⑤STV4R↑예측RCA폐새적민감성41.5%，특이성100%，양성예측치100%，음성예측치42.4%。⑥STⅠ등전위선예측 LCX 폐새적민감성78.6%，특이성70.8%，양성예측치53.7%，음성예측치88.5%。⑦STⅢ↑＜STⅡ↑예측LCX폐새적민감성71.4%，특이성92.3%，양성예측치80%，음성예측치88.2%。⑧STV3↓/STⅢ↑＞1.2예측LCX폐새적민감성57.1%，특이성78.5%，양성예측치53.3%，음성예측치80.9%。⑨STⅠ↑예측LCX폐새적민감성10.7%，특이성100%，양성예측치100%，음성예측치72.2%。결론：심전도Ⅰ、Ⅱ、Ⅲ、aVL도련급V3도련、V4R도련ST단개변능예측급성하벽심기경사환자경사상관혈관。
Objective:Through comparing the results of coronary angiography(CAG),to analyze the change characteristics of surface electrocardiogram(ECG) in patients with inferior wall acute myocardial infarction,in order to summarize the role of electrocardiogram in infarction related artery(IRA) among patients with inferior wall acute myocardial infarction(IAMI).Methods:93 patients with inferior wall acute myocardial infarctionand diagnosed as single coronary artery occlusion were selected,with 65 cases of right coronary artery(RCA) and 28 cases of left circumflex artery(LCX) in the infarct related artery.A retrospective study was carried out to analyze and compare the changes the ECG before infarct related artery(IRA) opening.Results:①The sensitivity of STⅢ↑>STⅡ↑ in predicting of RCA occlusion was 89.2%;the specificity was 85.7%;the positive predictive value was 93.5%;the negative predictive value was 77.4%.②The sensitivity of STV3↓/STⅢ↑≤1.2 in predicting of RCA occlusion was 78.5%;the specificity was 57.1%;the positive predictive value was 80.9%;the negative predictive value was 53.3%.③The sensitivity of STaVL↓>ST Ⅰ↓in predicting of RCA occlusion was 70.8%;the specificity was 78.6%;the positive predictive value 88.5%;negative predictive value was 53.7%.④The sensitivity of ST Ⅰ↓ in predicting of RCA occlusion was 70.8%;the specificity was 89.3%;positive predictive value was 93.9%;negative predictive value was 56.8%.⑤The sensitivity of STV4R↑ in predicting of RCA occlusion was 41.5%;specificity was 100%;the positive predictive value was 100%;negative predictive value was 42.4%.⑥The sensitivity of STⅠ equipotential line in predicting of LCX occlusion was 78.6%;the specificity was 70.8%;the positive predictive value was 53.7%;the negative predictive value was 88.5%.⑦The sensitivity of STⅢ↑<STⅡ↑ in predicting of LCX occlusion was 71.4%;the specificity was 92.3%;the positive predictive value was 80%;negative predictive value was 88.2%.⑧The sensitivity of STV3↓/STⅢ↑>1.2 in predicting of LCX occlusion was 57.1%;the specificity was 78.5%;the positive predictive value was 53.3%;the negative predictive value was 80.9%.⑨The sensitivity of STⅠ↑ in predicting of LCX occlusion was 10.7%;the specificity was 100%;the positive predictive value was 100%;negative predictive value was 72.2%.Conclusion:The changes in electrocardiogram I,II,III,aVL leads and V3 leads,V4R lead ST segment can predicted in infarction related artery among patients with inferior wall acute myocardial infarction.