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目的:探讨急性下壁心肌梗死伴与不伴右室梗死在常规心电图上的鉴别诊断。方法:选择2007-01/2008-12同期住院的急性下壁心肌梗死患者87例,其中单纯急性下壁心肌梗死45例,伴右室梗死42例。比较两组患者ST↑>ST↑、ST、aVL↓≥0.1mV、STaVR、V1↑等9项心电图指标。结果:ST>ST、qI、aVL、V5、V6消失;STV1～V5↑逐渐减小;STV2↓/STaVF↑<50%,合并房室传导阻滞等心律失常五项指标,两组比较差异显著(P<0.05)。STI、aVL↓≥0.1mV、STaVR↑、STaVR↓、STV1↑四项指标,两组比较无统计学差异(P>0.05)。结论:急性下壁心肌梗死患者伴有ST↑>ST↑、qI、aVL、V5、V6消失、STV1～V5↑逐渐减小、STV2↓/STaVF↑<50%心电图改变时,高度提示急性下壁心肌梗死伴有右室梗死。
Objective: To investigate the differential diagnosis of acute inferior myocardial infarction with and without right ventricular infarction in conventional electrocardiogram. Methods: A total of 87 patients with acute inferior myocardial infarction admitted to our hospital from January 2007 to December 2008 were enrolled. Among them, 45 cases were acute inferior myocardial infarction and 42 cases were right ventricular infarction. Comparing the two groups of patients ST ↑> ST ↑, ST, aVL ↓ ≥ 0.1mV, STaVR, V1 ↑ and other 9 ECG indicators. Results: ST> qI, aVL, V5, V6 disappeared; STV1 ~ V5 ↑ gradually decreased; STV2 ↓ / STaVF ↑ <50%, combined with atrioventricular block and other arrhythmia five indicators, the difference was significant (P <0.05). STI, aVL ↓ ≥0.1mV, STaVR ↑, STaVR ↓, STV1 ↑. There was no significant difference between the two groups (P> 0.05). CONCLUSIONS: ST ↑> ST ↑, qI, aVL, V5 and V6 disappear in patients with acute inferior myocardial infarction, while STV1 ~ V5 ↑ gradually decrease. When STV2 ↓ / STaVF ↑ <50% ECG changes, acute inferior wall Myocardial infarction with right ventricular infarction.