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目的探讨急性下壁心肌梗死早期心电图表现对高度房室阻滞的预测价值以及与冠状动脉病变的关系。方法分析97例急性下壁心肌梗死患者早期心电图(下壁导联)J/R≥0.5的发生情况,部分病例结合冠脉造影结果,探讨其对房室阻滞的预测价值。结果27例(21.6%)在心肌梗死急性期发生二度以上房室阻滞。有房室阻滞者,心电图下壁导联J/R≥0.5多于无房室阻滞者(69.56% vs 30.44%,p<0.01)。冠状动脉造影显示,有房室阻滞者,右冠状动脉近中段的高度狭窄明显多于无房室阻滞者(100% vs 58.33%)。结论急性下壁心肌梗死伴房室阻滞者的病损冠脉以右冠状动脉多见,下壁导联心电图J/R≥0.5对下壁心肌梗死合并房室阻滞的发生有一定的预测价值。
Objective To investigate the predictive value of early electrocardiogram (ECG) in patients with acute inferior myocardial infarction (AMI) on the severity of atrioventricular block and coronary artery disease. Methods 97 cases of acute inferior myocardial infarction in patients with early ECG (inferior leads) J / R ≥ 0.5 the occurrence of some cases combined with coronary angiography results to explore its predictive value of atrioventricular block. Results 27 cases (21.6%) had more than two degree atrioventricular block in the acute stage of myocardial infarction. In patients with atrioventricular block, J / R≥0.5 was lower than ECG without inferior ventricular block (69.56% vs 30.44%, p <0.01). Coronary angiography showed that in patients with atrioventricular block and right coronary artery, the stenosis was significantly higher than those without atrioventricular block (100% vs 58.33%). Conclusions The lesions of acute inferior myocardial infarction with atrioventricular block are more common in the right coronary artery. The ECG of inferior leads J / R≥0.5 has some predictive value for the incidence of inferior wall myocardial infarction with atrioventricular block value.