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目的探讨急性心肌梗死时心电图aVR导联QRS波群形态与冠状动脉造影梗死相关血管病变的对比分析。方法对45例急性下壁心肌梗死组、78例急性前壁心肌梗死组和80例对照组的心电图AVR导联QRS波群形态变化与冠状动脉造影(CAG)相关血管病变进行对比分析。结果 45例急性下壁心肌梗死患者组aVR导联QRS波群呈rs(S)型共计77.77%,80例对照组aVR导联QRS波群呈rs(S)型1.25%,P<0.01。Ⅰ、aVR导联的ST段抬高≥0.1mV时78例急性前壁心肌梗死患者组中为66.66%,对照组为6.25%,P<0.01;而Ⅱ、Ⅲ、aVF导联的ST段压低≥0.05mV时前者74.35%,后者18.75%,P<0.01。相关血管病变比较:45例下壁心肌梗死aVR导联ST段抬高伴Ⅱ、Ⅲ>Ⅰ、aVL导联ST段压低,冠脉造影为右冠状动脉(RCA)病变55.55%,aVR导联ST段压低≥0.1 mV为左前降支(LAD)病变44.44%。78例急性前壁心肌梗死aVR导联ST段抬高≥0.1 mV,冠脉造影为左主干(LM)病变51.28%,LM+RCA(右冠状动脉)病变48.71%,两组比较差异无统计学意义,P>0.05。80例对照组均无冠状动脉病变,与前两者无可比性。结论急性下壁心肌梗死后心电图aVR导联QRS波群多呈rs(S)型伴ST段抬高为右冠状动脉(RCA)病变,伴aVR导联ST段压低为左前降支(LAD)病变;急性前壁心肌梗死伴aVR导联ST段抬高以左主干(LM)病变为主。
Objective To investigate the relationship between QRS complex of aVR lead and infarction-related vascular lesions in patients with acute myocardial infarction (AMI). Methods The morphological changes of QRS complex of ECG AVR leads in 45 cases of acute inferior myocardial infarction, 78 cases of acute anterior myocardial infarction and 80 cases of control group were compared with those of coronary artery angiography (CAG). Results A total of 77 (77.77%) of QRS (a) was found in aVR lead in 45 patients with acute inferior wall myocardial infarction. The QRS of aVR lead was 1.25% (P <0.01) in 80 controls. Ⅰ, aVR leads ST segment elevation ≥ 0.1mV 78 cases of acute anterior myocardial infarction patients 66.66%, control group was 6.25%, P <0.01; and Ⅱ, Ⅲ, aVF ST segment depression The former is more than 0.05mV 74.35%, the latter 18.75%, P <0.01. Correlation of vascular lesion: ST segment elevation in aVR lead of 45 cases of inferior wall myocardial infarction with ST segment depression of Ⅱ, Ⅲ> Ⅰ, aVL leads, coronary angiography was 55.55% of RCA lesions, aVR lead ST Segmental depression ≥ 0.1 mV for the left anterior descending branch (LAD) lesions 44.44%. The ST segment elevation in aVR lead of 78 patients with acute anterior myocardial infarction was ≥0.1 mV, coronary angiography was 51.28% in the left main coronary artery (LM) and 48.71% in the LM + RCA (right coronary artery). There was no significant difference between the two groups Significance, P> 0.05.80 cases of the control group without coronary lesions, and the former two are not comparable. Conclusions The QRS complex of aVR lead of inferior wall acute myocardial infarction is predominantly rs (S) with ST segment elevation in right coronary artery (RCA) lesions. ST segment depression in aVR leads to left anterior descending (LAD) lesions Acute anterior myocardial infarction with aVR lead ST segment elevation in the main left main (LM) lesions.