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目的:探讨头胸导联(HC导联)心电图对右心室心肌梗死(RVI)的诊断价值。方法:对经临床、生化和冠状动脉造影证实的25例RVI患者进行心电图HC导联与 Wilson导联的同步对比观察。另选 49 例正常人作对照。结果:①对照组HC导联中HV3R~HV8R的QRS波多呈 Rs或 R型,越往右越明显,无≥2 个相邻导联出现Q波。②RVI者HV3R~HV8R的QRS波形态多为 QS形,且 HL3、HO、HR3 导联也以 QS型为主。25例RVI患者HC导联心电图的诊断符合率高于Wilson导联(84.0%∶52.0%,P<0.05)。③下壁梗死时,HL3、HO、HR3 导联Q波的出现与Wilson导联上Ⅱ、Ⅲ和aVF导联有很好的一致性。结论:RVI时HC导联心电图图形变化明显,所涉及的导联多,明显优于Wilson导联。
Objective: To investigate the diagnostic value of head-chest lead (HC lead) electrocardiogram in right ventricular myocardial infarction (RVI). Methods: Comparisons of ECG lead and Wilson lead in 25 RVI patients confirmed by clinical, biochemical and coronary angiography were performed. Another 49 cases of normal control. Results: ① The QRS of HV3R ~ HV8R in HC lead of control group were mostly Rs or R type, the more obvious to the right, no more than 2 adjacent leads Q waves. (2) The QRS patterns of HV3R ~ HV8R in RVI were mostly QS-shaped, and the leads of HL3, HO and HR3 were also mainly QS-type. The coincidence rate of HC lead ECG in 25 RVI patients was higher than that of Wilson lead (84.0%, 52.0%, P <0.05). ③ inferior wall infarction, HL3, HO, HR3 lead Q waves appear with Wilson leads Ⅱ, Ⅲ and aVF leads have good consistency. Conclusion: The ECG of HC lead shows obvious changes in RVI, involving more leads than Wilson lead.