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目的:探讨体表心电图改变在判断急性下壁心肌梗死相关动脉的价值。方法:根据冠状动脉造影结果将78例急性下壁心肌梗死患者分为右冠状动脉(RCA)组和左冠状动脉回旋支(LCX)组,比较2组患者的心电图改变。结果:①RCA组患者aVL导联ST段压低≥1 mm的发生率明显高于LCX组患者(92%∶24%,P<0.01);②RCA组患者aVL导联R/S比值明显低于LCX组[(2.7±0.4)∶(3.4±0.6),P<0.01];③aVL导联ST段压低≥1 mm和R/S比值≤3判断急性下壁心肌梗死相关动脉为RCA的敏感性、特异性、阳性预测值和阴性预测值分别为92%、90%、96%、77%和86%、95%、98%、70%。结论:aVL导联ST段压低和R/S比值缩小是判断急性下壁心肌梗死病变动脉为RCA的良好指标。
Objective: To explore the value of surface electrocardiogram (ECG) changes in judging the arteries of acute inferior myocardial infarction. Methods: According to the results of coronary angiography, 78 patients with acute inferior myocardial infarction were divided into right coronary artery (RCA) group and left coronary artery collaterals (LCX) group. Electrocardiographic changes were compared between the two groups. Results: ①The incidence of ST segment depression ≥1 mm in RCV group was significantly higher than that in LCX group (92%, 24%, P <0.01). ② The R / S ratio of aVL lead in RCA group was significantly lower than that in LCX group [(2.7 ± 0.4) :( 3.4 ± 0.6), P <0.01]. ③ The ST segment depression of aVL leads ≥1 mm and the R / S ratio ≤3 can be used to determine the sensitivity and specificity of RCA for acute inferior myocardial infarction The positive predictive value and negative predictive value were 92%, 90%, 96%, 77% and 86%, 95%, 98% and 70%, respectively. CONCLUSIONS: The reduction of ST segment depression and R / S ratio in aVL leads is a good indicator of RCA in patients with acute inferior myocardial infarction.