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目的 :探讨急性前壁心肌梗死合并下壁导联 ST段压低的临床意义。方法 :回顾性分析2 2例首发急性前壁心肌梗死患者的心电图、冠状动脉及左室造影资料。结果 :急性前壁心肌梗死时下壁导联 ( 、 、a VF) ST段下移≥ 0 .0 5 m V组与 <0 .0 5 m V组的 、a VL导联 ST80 值有显著性差异 ( P <0 .0 5 ) ;两组的左前降支 6段 ( LAD6 )或 LAD始部病变的发生率也有显著性差异 ( P <0 .0 5 ) ;下壁导联 ST段压低≥ 0 .0 5 m V对 L AD6 或 LAD始部病变预测价值的敏感性及特异性分别是 : 导联 5 9%、5 0 % ; 导联 83%、70 % ;a VF导联 83%、70 %。结论 :急性前壁心肌梗死时下壁导联ST段压低预示 LAD6 或 L AD始部病变是高前侧壁发生透壁性心肌缺血的“镜像”反应 ,表现为 、a VL导联 ST段抬高 ;它与右冠状动脉、左旋支、多支病变以及胸前导联 ST段抬高程度无关
Objective: To investigate the clinical significance of ST segment depression in acute anterior myocardial infarction with inferior leads. Methods: Electrocardiogram, coronary artery and left ventricular angiography data were retrospectively analyzed in 22 patients with acute anterior myocardial infarction. Results: There was a significant difference in the ST80 value of a VL lead between the ST segment of lower wall lead (, a VF) ≥0.05 mV group and <0.05 mm V group when acute anterior myocardial infarction (P <0.05). There was also a significant difference in the incidence of lesion of LAD6 or LAD among the two groups (P <0.05). ST segment depression in inferior leads ≥0 The sensitivity and specificity of .05 mV for the predictive value of the initial lesion of LAD6 or LAD were: 59% of leads, 50% of leads; 83% of leads; 70%; 83% of a VF leads, 70% %. CONCLUSIONS: ST-segment depression of the inferior leads in acute anterior myocardial infarction predicts that the onset of LAD6 or L-AD onset is a “mirror image” of transmyocardial ischemia in the anterior superior wall, as evidenced by the ST segment elevation of the VL lead High; it with the right coronary artery, left circumflex artery, multi-vessel disease and chest lead ST segment elevation has nothing to do