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目的探索avl导联ST段抬高对判断左冠状动脉阻塞位置的临床价值。方法将66例心肌梗死急性期常规心电图ST段变化与冠状动脉造影结果进行对比分析,观察avl及相关导联ST段变化在左冠状动脉阻塞中的定位价值。结果发现心肌梗死急性期若ST段抬高在avl及V2-V5导联,梗死相关血管最可能是左前降支近段(第一对角支发出前;)若ST段抬高在avl及V2导联,同时V3-V5ST段处于等电位线或压低,提示梗死相关血管是第一对角支;若ST段抬高仅在avl导联,合并胸导V1-V6ST段等电位线或轻微变化(上抬或下降<0.1mv),提示梗死相关血管为第一钝缘支。结论通过avl导联ST段抬高并结合其他导联ST段变化可较准确地判断急性心肌梗死左冠状动脉阻塞部位。
Objective To explore the clinical value of ST segment elevation in avl lead in determining the location of left coronary artery occlusion. Methods 66 cases of acute myocardial infarction ST segment changes of conventional electrocardiogram and coronary angiography results were compared and analyzed avl and related lead ST segment changes in left coronary artery occlusion in the value. The results showed that acute myocardial infarction if the ST segment elevation in the avl and V2-V5 lead, infarction-related blood vessels most likely to be proximal left anterior descending artery (first diagonal branch before the issue); if ST elevation in avl and V2 Lead, while V3-V5ST segment in the equipotential line or down, suggesting that infarction-related blood vessels is the first diagonal branch; if the ST segment elevation only in the avl lead, merger chest lead V1-V6ST section of the equipotential lines or slight changes (Up or down <0.1mv), suggesting that the infarct-related vascular first blunt margin. Conclusions ST segment elevation in avl lead and ST segment changes in other leads can be used to judge the location of left coronary artery occlusion in acute myocardial infarction.