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目的明确常规体表心电图下壁导联 ST段偏移对急性前壁心肌梗死患者左冠状动脉前降支 ( LAD)分布特点及其病变部位的判断价值。方法根据 L AD分布特点及其病变部位在第一对角支或第一间隔支的近端抑或远端 ,将 87例急性前壁心肌梗死患者进行分组 ,并比较各组患者的心电图改变。结果 1L AD近端病变组患者下壁导联 、 和 a VF的 ST段压低≥ 1mm的发生率明显高于远端组患者 ( :79%与 2 9% , :86 %与 19% ,a VF:75 %与 45 % ,P<0 .0 1) ;2左冠优势型组患者下壁导联 、 和 a VF的 ST段压低≥1mm的发生率明显优于非优势型组患者 ( :2 8%与 92 % , :2 8%与 94% ,a VF:31%与 96 % ,P<0 .0 1) ;3共 12例患者下壁导联ST段抬高总和≥ 3.0 mm,且均见于左冠优势型并 LAD远端病变患者。结论常规体表心电图下壁导联 ST段偏移是判断 LAD分布特点及其病变部位的良好方法
Objective To investigate the distribution of left anterior descending coronary artery (LAD) and its location in acute anterior wall myocardial infarction (AMI) in patients with acute anterior wall myocardial infarction. Methods 87 patients with acute anterior myocardial infarction were divided into groups based on the distribution characteristics of LAD and the proximal or distal part of the lesion in the first diagonal branch or the first septum. The changes of electrocardiogram in each group were compared. Results The incidence of ST segment depression ≥ 1 mm was significantly higher in patients with 1-L AD proximal disease than in distal patients (79% vs 29%, 86% vs 19%, a VF : 75% and 45% respectively, P <0.01). 2 The incidence of ST segment depression ≥1 mm in inferior left coronary artery was significantly superior to that in non-dominant coronary artery 8% vs 92%; 28% vs 94%, a VF: 31% vs 96%, P <0.01); 3 The total ST segment elevation in the inferior leads of 3 patients was ≥ 3.0 mm Are seen in the left coronary artery predominant and LAD distal lesions. Conclusion The ST segment deviation of the inferior leads of the general surface ECG is a good way to judge the distribution characteristics of LAD and its lesion site