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普通心电图对心肌梗塞的诊断和定位有很大价值,但尚不能测定梗塞范围和左心功能。Maroko等应用心前区多导联心电图标测法,观察犬冠状动脉结扎后体表心电图ST上升之总和(∑ST)与梗塞大小或心肌CPK活性减少量相关。Awan等亦用同样方法标测前壁心肌梗塞,其病理性Q波数目与左室射血分值、搏出功指数及心指数负相关,与左室收缩失调程度正相关。Askenazi等提出冠心病患者心电图R波振幅总和与左室射血分值相关。Selvester等用电子计算机模拟人类心电活动;显示不同梗塞部位和范围的QRS改变。并设计了一系列测定心肌梗塞范围的指标。随后,Wagner等将该法加以修改,并简化为用普通心电图QRS记分作为测定心肌梗塞范围的方法。本文介绍Wagner等设计的心电图QRS记分方法及其应用。
General ECG diagnosis and location of myocardial infarction great value, but not yet measured infarct size and left ventricular function. Maroko and other applications of precordial multi-lead ECG detection of canine coronary artery surface electrocardiogram after ST total rise (ΣST) and infarct size or myocardial CPK activity decreased. Awan et al. Also used the same method to detect anterior myocardial infarction. The number of pathological Q wave was negatively correlated with left ventricular ejection fraction, stroke workout index and cardiac index, positively correlated with the degree of left ventricular systolic dysfunction. Askenazi et al. Proposed that the sum of the amplitude of R wave in patients with coronary heart disease correlates with left ventricular ejection fraction. Selvester et al. Used computer simulations of human ECG activity; QRS changes at different infarct sites and ranges were shown. And designed a series of indicators to determine the scope of myocardial infarction. Subsequently, Wagner et al. Modified the method and simplified it as a method of determining the extent of myocardial infarction using the general electrocardiogram QRS score. This article introduces Wagner and other ECG QRS scoring method and its application.