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目的探讨16导联心电图中ST段改变对急性心肌梗死的临床诊断价值。方法对332例急性心肌梗死患者,在原有标准12导联的基础上,增加后壁导联(V7和V8)和右胸导联(V4R和V5R),观察附加导联中ST段改变,是否可提高心电图诊断急性心肌梗死的价值。结果12导联心电图诊断急性心肌梗死的敏感性为71.4%,特异性为86.0%;12导联+后壁导联诊断急性心肌梗死的敏感性为79.2%,特异性为85.0%;12导联+右胸导联诊断急性心肌梗死的敏感性为75.3%,特异性为84.5%;12导联+后壁+右胸导联诊断急性心肌梗死的敏感性为81.9%,特异性为83.7%。结论增加后壁和右胸导联可提高诊断急性心肌梗死的敏感性,而特异性并无显著降低。
Objective To investigate the clinical value of ST-segment changes in 16-lead electrocardiogram in acute myocardial infarction. Methods 332 patients with acute myocardial infarction, the original standard 12-lead, based on the addition of posterior wall leads (V7 and V8) and right chest lead (V4R and V5R), to observe the additional lead in ST segment changes, whether Can improve the value of ECG diagnosis of acute myocardial infarction. Results The sensitivity and specificity of 12-lead electrocardiogram in diagnosis of AMI were 71.4% and 86.0% respectively. The sensitivity and specificity of 12-lead + posterior wall guidewire in diagnosis of AMI were 79.2% and 85.0% + Right chest lead was 75.3% for diagnosis of acute myocardial infarction and 84.5% of specificity. The sensitivity and specificity of 12-lead + posterior wall + right-hand lead in diagnosis of AMI were 81.9% and 83.7% respectively. Conclusions The increase of posterior wall and right chest lead can improve the sensitivity of diagnosis of acute myocardial infarction, but the specificity is not significantly reduced.