温宇梅;郭金成;高国旺;张海滨;张正海;刘长虹;

• 1:北京市通州区潞河医院心内科

摘要(Abstract)：

目的探讨急性下壁心肌梗死时心电图ST段改变对心肌梗死梗死相关动血管(IRA)的判断价值。方法通过对84例急性下壁心肌梗死的患者的心电图Ⅰ、aVL、Ⅱ、Ⅲ、aVR、V5、V6导联ST段偏移进行分析,并与冠状动脉造影结果进行对比。结果 (1)IRA为右冠状动脉(RCA)68例,左冠状动脉回旋支(LCX)16例。(2)ST↑Ⅲ>ST↑Ⅱ提示IRA为RCA的敏感性是93%,特异性是94%,阳性预测值(PPV)是98%,阴性预测值(NPV)是79%;ST↑Ⅲ1.2提示IRA为LCX的敏感性是81%,特异性是97%,PPV是87%,NPV是97%。(4)ST↓aVL>ST↓I提示IRA为RCA的敏感性是91%,特异性是81%,PPV是95%,NPV是68%。(5)aVR导联ST段压低提示IRA为RCA的敏感性是88%,特异性是87%,PPV是97%,NPV是64%;aVR导联ST段抬高提示IRA为LCX的敏感性是81%,特异性是94%,PPV是76%,NPV是95%。(6)Ⅱ、Ⅲ、aVF导联ST段抬高伴V5、V6导联ST段抬高对梗死相关血管为RCA或LCX无预测价值。结论常规12导联心电图ST段偏移对判断急性下壁心肌梗死梗死相关血管有重要的预测价值。

关键词(KeyWords)： 急性下壁心肌梗死;心电图;右冠状动脉;左冠状动脉回旋支

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作者(Author): 温宇梅;郭金成;高国旺;张海滨;张正海;刘长虹;

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参考文献(References)：

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