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目的 :探讨应用心电图判断急性下壁心肌梗死患者梗死相关动脉 (IRA)的可行性与准确性 .方法 :回顾性分析 36例首次急性下壁心肌梗死患者的入院心电图与冠状动脉造影资料 .结果 :急性下壁心肌梗死患者多有右冠状动脉 (RCA)病变 (88.6 % ) ,多数 (6 6 .7% )患者有两支以上病变。IRA的分布也是 RCA多于左旋支 (L CX) ,分别占 86 .1%和 13.9%。对心电图指标 (ST ,STa VL,STV1 或 V2 ,STV2 + a VF,STV2 + ,STV5 或 V6 ,ST / )与 IRA关系的统计分析表明 ,前五组未出现显著差异。STV5 或 V6 在 RCA组多为下降 ,L CX组多为抬高而无 1例下降 (P<0 .0 5 ) ;但排除 RCA和 L CX皆有显著病变的病例后 P>0 .0 5。 ST / 在 RCA组绝大多数小于 1而 L CX组多大于 1(P<0 .0 1) ;排除 RCA和 L CX皆有显著病变的病例后仍然 P<0 .0 1。结论 :ST / 比值是判断急性下壁心肌梗死患者IRA的较准确的心电图指标。
Objective: To investigate the feasibility and accuracy of using electrocardiogram (ECG) to determine the infarct-related artery (IRA) in patients with acute inferior myocardial infarction.Methods: The electrocardiogram and coronary angiography data of 36 patients with first acute inferior myocardial infarction were retrospectively analyzed.Results: More patients with acute inferior myocardial infarction have right coronary artery (RCA) lesions (88.6%), and most (66.7%) have more than two lesions. The distribution of IRA was also more RCA than L-branch (L CX), accounting for 86.1% and 13.9% respectively. The statistical analysis of the relationship between ECG indicators (ST, STa VL, STV1 or V2, STV2 + a VF, STV2 +, STV5 or V6, ST /) and IRA showed that there was no significant difference in the first five groups. STV5 or V6 mostly decreased in the RCA group, but elevated in the L CX group but not in 1 case (P <0.05), but no significant difference was found between the RCT group and the L CX group (P> 0.05) . ST / P values were less than 1 in the RCA group and more than 1 in the L CX group (P <0.01); P <0.01 after excluding significant RCA and L CX cases. Conclusion: The ST / ratio is a more accurate ECG for judging IRA in patients with acute inferior myocardial infarction.