关键词: 心电描记术;急性病;心肌梗塞;预后;冠状血管造影术

    摘 要:目的 探讨ECGⅢ导联ST段抬高大于Ⅱ导联对急性下壁心肌梗死患者近期预后的影响及与梗死相关动脉的关系. 方法 按体表ECGⅡ导联和Ⅲ导联ST段抬高的不同，将47例首次急性下壁心肌梗死患者分为两组:A组(STⅢ >STⅡ )39例，B组(STⅡ >STⅢ )8例，所有患者均行冠状动脉造影检查，统计两组患者的临床特点、住院期间严重并发症的发生率和住院4周内的死亡率及两组梗死冠状动脉部位. 结果 A组患者心肌酶CK-MB峰值(3634±1450)nkat·L-1 明显高于B组(1650±883)nkat·L-1 ，统计学有非常显著差异(P<0.01);A组患者合并右室梗死、胸前导联ST段压低、并发高度房室传导阻滞、心源性休克的发生率和住院死亡率分别为38.5%，43.6%，43.6%，38.5%，35.8%，B组无上述合并症的发生，两组比较有显著性差异(P<0.05);而性别、年龄、合并高血压、糖尿病、并发室性心律失常、左心衰竭在两组间无显著性差异(P>0.05).冠脉造影显示A组患者右冠状动脉近段闭塞或狭窄的发生率为38.5%，而B组无1例发生，两组比较有显著性差异(P<0.05);B组患者左回旋支闭塞或狭窄的发生率为50%，而A组无1例发生，两组比较有非常显著差异(P<0.01);而其他梗死相关动脉在两组间无显著性差异(P>0.05). 结论 ECGⅡ，Ⅲ导联ST段抬高的不同幅度，对预测急性下壁心肌梗死患者近期预后和梗死相关动脉有一定的价值.

    Significance of greater ST┐segment elevation in leadⅢthan in leadⅡin patients with acute inferior myocardial infarction

    GAO Yu-Qi，ZHONG Ping，LI Zhi-Liang

    Department of Cardiology，Zhujiang Hospital，First Military Medical University，Guangzhou510282，China

    Keywords:electrocardiography;acute disease;myocardial in-farction;prognosis;coronory angiography

    Abstract:AIM To observe the effect of greater ST segment elevation in leadⅢthan in leadⅡin acute phage on short-term prognosis and occluded coronary artery in patients with acute inferior myocardial infarction(AIMI).METHODS 47patients with first AIMI were divided into2groups according to the amplitude of ST segment elevation in leadⅡand leadⅢof a12lead eletrocardiogram:Group A(39cases with greater ST segment elevation in leadⅢthan in leadⅡ ......