论文部分内容阅读
心肌缺血和梗塞常可根据体表心电图改变加以识别:ST 段上升反映透壁性缺血及/或梗塞,ST段下降则表示心内膜缺血及/或梗塞。ST 段下降原理:心肌供血不足首先损及心内膜下区。心内膜下区缺血时,细胞内 K~+迅速丢失,于是产生一种指向心外膜的舒张期损伤电流,以致心电图基线(TQ 段)上升。心肌细胞(包括受损细胞)除极时无损伤电流,结果 ST 段下降;心室收缩完成后,ST 段又回到上升了的舒张期基线水平.冠脉阻塞时 ST 段反应:ST 段下降患者,冠脉侧支循环丰富,心肌缺血程度较轻;相反,严重、广泛缺血则产生 ST 段上升.这已为冠脉造影证实。ST 段下降伴有胸痛患者,冠脉阻塞多半不完
Myocardial ischemia and infarction can often be identified by changes in the surface ECG: ST segment elevation reflects transmural ischemia and / or infarction, and ST segment depression indicates endocardial ischemia and / or infarction. ST segment descending principle: Insufficient myocardial blood supply first of all, and subendocardial area. When subendocardial ischemia occurs, intracellular K ~ + is quickly lost, resulting in a diastolic lesion current directed toward the epicardium, resulting in an increase in baseline ECG (TQ segment). Myocardial cells (including damaged cells) depolarized without damage current, the results of ST segment decreased; ventricular contraction is completed, ST segment was back to the baseline level of diastolic rise. ST segment of coronary artery occlusion: ST-segment depression , Coronary collateral circulation rich, mild myocardial ischemia; on the contrary, severe, extensive ischemia is the ST segment rise.This has been confirmed by coronary angiography. Patients with ST-segment depression accompanied by chest pain, coronary artery obstruction mostly incomplete