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目的探讨急性前壁透壁性心肌梗死时下壁导联ST段压低的临床价值。方法比较任一下壁导联ST段压低≥1.0 mm的17例与压低均<1.0 mm的16例的CK-MB值、超声心动描记术、冠状动脉造影等结果。结果前组CK-MB值更高,射血分数减低更显著,左室收缩与舒张末期容积更大,造影术示致梗死狭窄病变多位于左前降支近端或呈多支病变。结论急性前壁心肌梗死下壁导联ST段压低≥1.0 mm时,其梗死面积较大,会发生较严重的左室射血功能损害及左心室重构。
Objective To investigate the clinical value of inferior ST segment depression in acute anterior transmural myocardial infarction. Methods The results of CK-MB, echocardiography and coronary angiography were compared among 17 cases with ST-segment depression ≥1.0 mm in inferior wall lead and 16 cases with depression in all <1.0 mm. Results Before treatment, the CK-MB value was higher, the ejection fraction decreased more significantly, and the volume of left ventricular systole and end-diastole was larger. The infarct stenosis induced by angiography was more in the proximal or anterior branch of left anterior descending artery. Conclusions ST segment depression in the inferior anterior wall myocardial infarction leads to a large infarct size when the ST segment depression is greater than or equal to 1.0 mm, leading to severe left ventricular ejection dysfunction and left ventricular remodeling.