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本文选择30例死于下壁心肌梗塞的病人,男性18例,女性12例。按尸检结果分为两组:第一组21例,具有肉眼可见的左室下壁心肌梗塞并不同程度地累及右室;第二组9例,仅有局限性左室下壁心肌梗塞。对照分析两组病人入院时右胸导联(V_(4R)、V_(3R)、V_1)ST段及QRS改变。并对82例无心肺疾病者进行常规12导联加4个右胸导联(V_(6R)—V_(3R))的心电图检查。结果两组病人除Ⅱ、Ⅲ、aVF显示ST段抬高和病理性Q波外,第一组中16倒ST_(V4R)抬高,13例ST_(V4R),V_(3R)同时抬高。11例ST_(V4R)-v_1同时抬高。第二组除1例V_(4R)抬高外,余右胸导联无ST段抬高。第一组17例病人除4例因出现室内阻滞或在发病后24小时内死亡而未作分析,17例中有16例V_(4R)出现QS波,13例V_(4R),V_(3R)同时出现QS波,12例V_(4R)、V_1同时出现QS波;第二组除1例V_(4R)出现
In this paper, 30 patients died of inferior myocardial infarction, 18 males and 12 females. The autopsy results were divided into two groups: the first group of 21 cases, with macroscopic left inferior wall myocardial infarction and varying degrees of involvement of the right ventricle; the second group of 9 patients, only limited left inferior myocardial infarction. The right chest lead (V_ (4R), V_ (3R), V_1) ST segment and QRS changes were compared between the two groups. Eighty-two patients without heart-lung disease underwent routine 12-lead electrocardiography with four right chest leads (V_ (6R) -V_ (3R)). Results In addition to ST segment elevation and pathological Q wave in Ⅱ, Ⅲ and aVF groups, 16 inverted ST_ (V4R) were elevated in the first group, and 13 cases of ST_ (V4R) and V_ (3R) elevated simultaneously in the two groups. 11 cases of ST_ (V4R) -v_1 elevated at the same time. In the second group, except for one case of V_ (4R) elevation, there was no ST-segment elevation in the leads of the right chest. In the first group of 17 patients, 4 cases were left uninvolved due to internal block or death within 24 hours after onset. Among the 17 cases, 16 cases of V 4R presented QS wave, 13 cases of V 4R, V_ 3R) appeared QS wave, 12 cases of V_ (4R), V_1 at the same time QS wave; the second group except for one case of V_ (4R)