论文部分内容阅读
目的 对 5 0例急性下壁心肌梗死患者的心电图进行分析并与冠状动脉造影的结果进行比较 ,以揭示体表心电图对梗死相关动脉的预测价值。 方法 根据冠状动脉造影的结果将 5 0例急性下壁心肌梗死患者分为 3组 :右冠状动脉 (right coronary artery,RCA)闭塞组 2 4例 ,左回旋支 (left cir-cum flex artery,L CX)闭塞组 17例 ,右冠状动脉及左回旋支 (RCA+ L CX)同时闭塞组 9例。结果 (1)RCA组 ST 抬高 >ST 抬高的发生率明显高于 L CX组及 RCA+ L CX组 (P<0 .0 0 5 ) ,灵敏度、特异度、诊断符合率、阳性预测值及阴性预测值分别为 87.5 %、84.6 %、86 %、84%、86 % ;L CX组与 RCA+ L CX组后壁导联梗死图形的发生率明显高于 RCA组 (P<0 .0 0 5 ) ,阴性预测值分别为 84.6 %、10 0 % ;RCA组及 RCA+ L CX组右心室梗死的发生率明显高于 L CX组 (P<0 .0 1) ;(2 ) RCA组及 RCA+ L CX组侧壁导联 ST段下移的发生率及 STa VL下移 >STI 下移的发生率明显高于 L CX组 (P<0 .0 0 5～ 0 .0 5 ) ,其中a VL 导联 ST段下移及 STa VL 下移 >STI 下移对各自梗死相关动脉的阴性预测值分别为 76 .2 %、90 .5 %、73.3%、83.3% ;L CX组前壁导联 ST段下移的发生率明显高于 RCA组及 RCA+ L CX组 (P<0 .0 0 5～ 0 .0 5 ) ,其灵敏度、特
Objective To analyze the electrocardiogram of 50 patients with acute inferior myocardial infarction and compare them with those of coronary angiography to reveal the predictive value of body surface electrocardiogram for infarct related arteries. Methods According to the results of coronary angiography, 50 patients with acute inferior myocardial infarction were divided into 3 groups: 24 cases of right coronary artery (RCA) occlusion group, left cir-cum flexion artery (L) CX) occlusion group, 17 cases of right coronary artery and left circumflex artery (RCA + L CX) occlusion group, 9 cases. Results (1) The incidence of ST elevation> ST elevation in RCA group was significantly higher than that in L CX group and RCA + L CX group (P <0.05). The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and The negative predictive value was 87.5%, 84.6%, 86%, 84%, 86% respectively. The incidence of infarction pattern in posterior wall leads of L CX group and RCA + L CX group was significantly higher than that of RCA group (P <0.05) ), And the negative predictive value were 84.6% and 100% respectively. The incidence of right ventricular infarction in RCA group and RCA + L CX group was significantly higher than that in L CX group (P <0.01). (2) RCA group and RCA + L group The incidence of ST-segment downstaging and STa down-shift> STI down-shift in the lateral leads of CX group were significantly higher than those in L CX group (P <0.05-0.050) The negative predictive values of ST-segment depression and STa VL-down> STI-down on their respective infarct-related arteries were 76.2%, 90.5%, 73.3% and 83.3%, respectively. The ST segment The incidence of down-shift was significantly higher than that of RCA group and RCA + L CX group (P <0.05-0.05), and its sensitivity, specificity