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目的：根据临床资料探讨急性下壁心肌梗塞（AIMI）V1－V4导联ST段下移（STD）的临床意义。方法和结果：AIMI61例，STD≥0．1mv30例（A组），＜0．lmv31例（B组）。分别比较A和B组临床因素和冠心病死亡发生率：其中肺部罗音、心功能Ⅱ～Ⅳ级及Ⅳ级、Ⅲ度房室传导阻滞、持续性低血压休克综合征及住院期内冠心病死亡率A组均显著高于B组（均P＜0．01）。而A组STD导联数≥3（∑ST≥3）的心功能≥Ⅲ级、休克综合征和住院期内死亡率显著高于∑ST≤2者（P＜0．05）；STD均值XST≥0．2mv住院死亡率也显著高于XST≥0．1（＜0．2）my，（P＜0．05）。结论：该组结果表明AIMIV1－V4导联STD≥0．1mv预示高危亚组；兼有∑SF≥3者发生高危事件危险性进一步增加；而同时有XST≥0．2mv和∑ST≥3者发生最高危心脏事件的危险性最大。
Objective: To investigate the clinical significance of ST segment depression (STD) in lead V1-V4 of acute inferior wall myocardial infarction (AIMI) based on clinical data. Methods and results: AIMI61 cases, STD≥0.1mv30 cases (A group), <0. lmv31 cases (group B). The clinical factors and the incidence of coronary heart disease in group A and group B were compared respectively. Among them, pulmonary rales, cardiac function grade Ⅱ ~ Ⅳ, grade Ⅳ, Ⅲ degree atrioventricular block, persistent hypotensive shock syndrome and inpatient period Coronary heart disease mortality was significantly higher in group A than in group B (all P <0.01). In group A, the cardiac function≥3 (ΣST≥3) of STD leads≥Ⅲ, and the mortality rate in shock syndrome and inpatient period was significantly higher than that in ΣST≤2 (P <0.05). The mean of STD mean XST The hospital mortality rate of ≥ 0.2mv was also significantly higher than that of XST≥0.1 (<0.2) my (P <0.05). Conclusion: The results of this group show that STD≥0.1mv of AIMIV1-V4 lead to high-risk subgroup, and the risk of high-risk event with both ΣSF≥3 is further increased; while those with XST≥0.2mv and ΣST≥3 The highest risk of heart attack the most dangerous.