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目的：探讨前壁急性心肌梗死（AMI）时心电图（ECG）下壁导联ST段压低的意义。方法：对59例前壁AMI病人（甲组29例伴下壁导联ST段压低、乙组30例不伴下壁导联ST段压低）的ECG及发病2个月内选择性冠状动脉造影和同位素心肌灌注显像检查结果对照分析。结果：①选择性冠状动脉造影显示冠状动脉病变（狭窄＞50．00％）支数在两组间的分布无显著差异（P＞0．05）；左心室造影两组均未见下壁运动明显减弱。②同位素心肌灌注显示甲组病人86．21％无下壁心肌缺血表现。③甲组ECGV1-3导联ST段抬高和的平均值明显高于乙组（P＜0．05），ECG下壁导联ST段压低主要受V1-3导联ST段抬高程度的影响（r＝-0．528，P＜0．05）。结论：前壁AMI时ECG下壁导联ST段的压低可能是对前壁V1-3导联ST段抬高的镜影反映，而不提示伴有下壁心肌缺血。
Objective: To investigate the significance of ST-segment depression in the inferior leads of ECG on acute myocardial infarction (AMI) in anterior wall. Methods: The ECG of 59 anterior AMI patients (ST segment depression in 29 cases with inferior wall leads and ST-segment depression in 30 cases in B patients without inferior leads) in the anterior wall and selective coronary angiography within 2 months And isotope myocardial perfusion imaging test results of controlled analysis. Results: ①Coronary angiography showed no significant difference in the distribution of coronary artery lesions (> 50.00%) between the two groups (P> 0.05); neither left ventricular wall motion was observed in the left ventricular angiography Obviously weakened. ② Isotope myocardial perfusion showed that 86.21% of patients in group A had no inferior myocardial ischemia. ③ The average value of ST segment elevation in ECGV1-3 leads of group A was significantly higher than that of group B (P <0.05). The ST segment depression of ECG leads was mainly affected by the level of ST elevation in V1-3 lead Effect (r = -0.528, P <0.05). CONCLUSIONS: The ST-segment depression of the ECG leads in the anterior wall may be a mirror image of the ST-segment elevation of the anterior wall V1- 3 leads, but not with the inferior myocardial ischemia.