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目的：探讨急性下壁心肌梗死心电图胸前导联ＳＴ段下降与前降支病变的关系。方法：对７７例急性下壁心肌梗死患者入院时心电图和冠状动脉造影资料进行分析，并根据入院时心电图胸前导联ＳＴ段下降范围将患者分为４组。Ｉ组（ｎ＝１２）：Ｖ１～３导联ＳＴ段下降；Ⅱ组（ｎ＝１２）：Ｖ４～６导联ＳＴ段下降；Ⅲ组（ｎ＝３５）：Ｖ１～５或Ｖ１～６导联ＳＴ段下降；Ⅳ组（ｎ＝１８）：胸前导联ＳＴ段无明显下降。结果：Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组前降支病变发生率分别为８％、７５％、７４％和２８％，其前降支狭窄程度≥９０％者Ⅱ组、Ⅲ组分别占２２％、５８％；Ⅰ组前降支病变发生率８％；Ⅳ组前降支病变的发生率为２８％，但其前降支狭窄程度均＜９０％。结论：急性下壁心肌梗死伴前壁（Ｖ１～５导联）或广泛前壁（Ｖ１～６导联）及前侧壁（Ｖ４～６导联）ＳＴ段下降者大多合并前降支病变，前者ＳＴ段下降的主要原因是由于前降支严重狭窄病变致前壁心内膜下心肌缺血，后者则可能更多与心肌梗死相关血管有关。而Ｖ１～３导联ＳＴ段下降则考虑是一种对应性变化。
Objective: To investigate the relationship between ST segment depression and anterior descending coronary artery in acute inferior myocardial infarction (ECG). Methods: The electrocardiogram and coronary angiography data of 77 patients with acute inferior myocardial infarction on admission were analyzed. The patients were divided into 4 groups according to the descending range of ST segment on admission. In group I (n = 12), the ST segment was decreased in leads V1 ~ 3; in group Ⅱ (n = 12), the ST segment was decreased in V4 ~ ST-segment depression; Ⅳ group (n = 18): chest lead ST segment no significant decline. Results: The incidence of anterior descending coronary artery disease in group Ⅰ, group Ⅱ, group Ⅲ and group Ⅳ were 8%, 75%, 74% and 28%, respectively. The degree of anterior descending coronary artery stenosis was 90% 22%, 58%. The incidence of anterior descending coronary artery in group Ⅰ was 8%. The incidence of anterior descending coronary artery in group Ⅳ was 28%. However, the degree of anterior descending coronary artery stenosis was less than 90%. CONCLUSION: Most of patients with acute inferior myocardial infarction with anterior descending wall (V1 ~ 5 leads) or extensive anterior wall (V1 ~ 6 leads) and anterior ST segment descending (V4 ~ 6 leads) The former is the main cause of ST-segment decline due to severe anterior descending coronary artery stenosis caused by subendocardial myocardial ischemia, the latter may be more associated with myocardial infarction-related. The V1 ~ 3 lead ST segment decline is considered a correspondence change.