avr导联对急性下壁心肌梗死罪犯血管的预测价值

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1、维普资讯http://www.cqvip.com·258·中华，律赏学杂志2O8月第l0卷第4期ChinJCardiacArrhyth，2006，Vol10No．4·临床研究·aVR导联对急性下壁心肌梗死罪犯血管的预测价值邓敏宋建平蒋廷波杨向军刘志华蒋文平【摘要】目的通过与冠状动脉造影(CAG)对比，研究aVR导联sT段改变的特征对急性下壁心肌梗死的相关动脉定位的意义。方法对比65例急性心肌梗死，其中右冠状动脉近段闭塞26例、右冠状动脉远段闭塞29例、左叫旋支(I,CX)闭塞10例，分析在病人胸痛发作12h内的心电图变化。结果：组病人下壁导联的sT段抬高差异无

2、统计学意义，伴aVR导联sT段压低，提示右冠状动脉(RCA)闭塞，如4：伴aVR导联段低，则提示LCX闭塞右冠状动脉近段闭寒，不影响胸前导联sT段，心电图指标阳性预测值96．7％；右冠状动脉远段闭塞则构成V．～V导联srr段压低，阳性预测值83％；LCX『才】塞虽不影响aVR导联段，但构成V．～V导联sT段压低，阳性预测值87％。结论急性下壁心肌梗死早期除下壁导联sT段抬高外，是否合并aVR导联srr段压低，是区别RCA闭塞或LCX闭塞的关键指标，对预后和决定是否采取血管厦建治疗具有重要的参考价值。【关键词】急性下壁心肌梗死；心电图；冠状动脉造影；梗死相关动脉

3、ThevalueofleadaVRtopredicttheculpritvesselintheacuteinferiormyocardialinfarctionDENGMin，SONGJian—ping，JIANGTing—bo，YANGXiang—Jun，LIUZhi—hua，JIANGWen—Ping．Departmentofger—atology，YangzhouUniversityCollegeofClinicalMedicine，Yangzhoa225001，China【Abstract】ObjectiveTopredicttheinfarctrel

4、atedarte~(IRA)inacuteinferiormyocardialinfar~一tion(AMI)withST—segmentchangesofleadaVR，throughcomparingtheelectrocardiogramtocoronaryangiogra—phy(CAG)．MethodsSixty—fivepatientswithinferiorAM1wereenrolled，ofwhich，proximaltotherightcoro—naryarteryocclusionwaspresentin26，distaltotherigh

5、tcoronaryarteryin29，andleftcircumflexcoronaryar'tery(LCX)occlusionin10．Analyzecomparativelythechangesofelectrocardiogramregisteredin12hours'aftertheacuteepisode．ResultsInthethreegroups，markedSTelevationininferiorleadsshowednosignificance，withSTvRdepressionsuggestedtherightcoronaryar

6、tery(RCA)occlusionandwithoutST¨{depressionsug—gestedLCXoeelusion．Theproximaltotherightcoronaryarteryocclusiondidn’tinfluenceST—segmentchanges，．andthepositivepredictivevalue(PPV)ofeIectrocardiogramindexwas96．7％．ThedistaltotherightcoronaryarteryocclusioncontributedST、ldepression，andth

7、ePPVwas83％．TheLCXocclusionalsocontributed～、STvdepression，}1utdidn’tinfluencedST。vR，andthePPVwas87％．ConclusionAtthesametimeofST一elevationininferiorlead，withorwithouttheST、RdepressionisthekeypointtodistinguishtheRCAorI,CXocclusionintheearlyinferiorAMI，whichtakesontheimportantreference

8、valuetodeterminethe