摘要
目的分析不同梗死相关血管的急性下壁心肌梗死患者的临床特点。方法根据冠状动脉造影结果将急性下壁心肌梗死患者分2组，A组76例为右冠状动脉（RCA）闭塞，B组24例为左回旋支冠状动脉（LCX）闭塞，并进行比较分析。结果心电图ST段抬高STⅢ〉STⅡ A组显著高于B组（P〈0．05）；ST段抬高STⅢ〈STⅡA组显著低于B组（P〈0．01）；STV4R抬高〉0．1mVA组显著高于B组（P〈0．05）；合并左前降支冠状动脉（LAD）病变的患者数在胸前导联ST段压低的患者中显著多于无胸前导联ST段压低患者（P〈0．05）；左室射血分数（LVEF）A组显著低于B组[（51±14）％vs（57±10）％，P〈0．05]；合并右室心肌梗死A组显著高于B组（P〈0．05）；心源性休克，心力衰竭，Ⅱ度、Ⅲ度房室传导阻滞，室性心动过速，心室颤动，住院死亡率等两组比较差异无统计学意义（P〉0．05）。结论心电图Ⅲ、Ⅱ及V4R导联ST段变化能预测急性下壁心肌梗死患者梗死相关血管，急性下壁心肌梗死患者伴胸前导联ST段压低提示LAD病变，RCA闭塞所致下壁心肌梗死LVEF低于LCX闭塞者，但临床并发症两组间差异无统计学意义。
Objective To study the clinical characteristics of patients with acute inferior wall myocardial infarction spring from different occulded arteries. Method patients with acute inferior wall myocardial infarction were divided into 2 groups according to coronary angiograms. Group A included 76 patients with right coronary artery occlusion and 24 patients with left circumflex artery occlusion in group B. Their clinical features were studied. Results On the eectrocardiogram （ECG） the number of ST segment elevation STⅢ 〉 STⅡ in group A was significantly higher than that in group B （ P 〈 0.05） ; The number of ST segment elevation STⅢ 〈 STⅡ in group A was significantly lower than that in group B （ P 〈 0.001 ） ; The number of STV4R elevation 〉 0.1 mV in A group was significant higher than that in group B （P 〈 0.05 ）; The number with lesion of left anterior descending coronary in patients with precordial leads ST segment depression 〉 0.1 mV was significantly higher than that without precordial leads ST segment depression （ P 〈 0.05 ）. Left ventricular ejection fraction （LVEF） of group A was significant less than that of group B [ （51 ± 14） % vs （57 ± 10） %, P 〈 0.05 ] ; The patients in group A with right ventricular infarction, LVEF was significantly greater than that in group B （ P 〈 0.05） ; There was of no significant difference between the two groups about the incidence of cardiogenic shock, heart failure, Ⅱ degree and Ⅲ degree atrial ventricular block, ventricular tachycardia/ ventricular fibrillation and the mortality in during hospital stay. Conclusions The changes of ST segment of ECG in Ⅲ, Ⅱ and V4R leads can predict the related coronary artery occluded involving in acute inferior wall myocardial infarction. When patients take precordial leads, ST segment depression indicate lesion of LAD. The LVEF of patients with RCA occlusion is less than that with LCX occlusion. But there was of no significant difference between 2 groups in complications.
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第4期366-368,共3页
Chinese Journal of Emergency Medicine
关键词
急性下壁心肌梗死
ST段
梗死相关血管
Acute inferior wall myocardial infarction
ST segment
Related infarct coronary artery
