目的：探讨心电图对准确预测前壁急性心肌梗死（ＡＭＩ）时冠状动脉前降支（ＬＡＤ）闭塞位置的作用。方法：对９４例前壁ＡＭＩ患者的心电图和冠状动脉造影资料进行分析。结果：①前间隔ＡＭＩ患者前降支闭塞位置大都发生在第１间隔支和第１对角支开口远端，且单支病变多见。②前壁和前壁伴高侧壁ＡＭＩ患者前降支闭塞位置发生在第１间隔支与第１对角支开口近端的发生率分别为２８９％与２６３％和５５０％与４７５％。前壁伴高侧壁ＡＭＩ患者若以大的对角支作为解剖分界进行分析，则８００％其血管闭塞位置在大的对角支发出前，若以ａＶＬ导联ＳＴ段抬高＞１ｍｍ，Ⅲ、ａＶＦ导联ＳＴ压低＞１ｍｍ为标准，预测血管闭塞位置在第１对角支开口近端和大对角支开口近端的发生率分别为６９２％和９２３％。③前壁伴下壁ＡＭＩ者前降支闭塞位置均发生在第１间隔支开口远端。结论：心电图对前壁ＡＭＩ时前降支的闭塞位置有重要的预测价值 Objective: To investigate the role of electrocardiogram in accurately predicting the location of occlusion of anterior descending coronary artery (LAD) in anterior wall acute myocardial infarction (AMI). Methods: The electrocardiogram and coronary angiography data of 94 patients with anterior AMI were analyzed. Results: ① The anterior descending coronary artery occlusion occured in the first anterior segmental AMI mostly occurred in the distal part of the first septum branch and the first diagonal branch, and single vessel lesion was more common. ② The incidence of anterior descending artery occlusion in the anterior wall and the anterior wall with high side wall AMI occurred in 28.9% and 26.3%, respectively, and in the proximal part of the first diagonal branch, with an interval of 289% and 550 % And 47  5%. If the anterior wall with high side wall AMI patients with large diagonal branch as anatomical boundaries were analyzed, 80% of its vascular occlusion position in the large diagonal branch before, if aVL lead ST segment elevation> 1mm , Ⅲ, aVF lead ST depression> 1mm as the standard, predict the location of vascular occlusion in the proximal opening of the first diagonal branch and the opening of the large diagonal branch of the incidence were 69  2% and 92  3%. ③ anterior wall with the inferior wall AMI who had anterior descending artery occlusion occurred at the first interval of the distal opening of the branch. Conclusion: ECG has an important predictive value for occlusion position of anterior descending artery in anterior wall AMI