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目的通过与冠状动脉造影(CAG)的对比,探讨心电图V4R导联ST-T改变对急性下壁心肌梗死(AIMI)的梗死相关冠脉(IRA)的判断价值。方法对比分析82例急性下壁心肌梗死患者的心电图和冠状动脉造影结果,按V4R导联ST-T改变分为3型,Ⅰ型:STV4R↑≥1mm,T波直立;Ⅱ型:0mm1发生率均明显高于回旋支(LCX)组(p<0.05),符合Ⅰ型标准者在RCAp组中的发生率明显高于RCAd组及LCX组(p<0.05),敏感性87.0%,特异性81.8%;符合Ⅱ型标准者在RCAd组发生率明显高于RCAp组及LCX组(p<0.05);符合Ⅲ型标准者在LCX组中明显高于RCAp及RCAd(p<0.05)组。结论急性下壁心肌梗死时,V4R导联ST-T特征性改变对于梗死相关动脉(IRA)的定位具有重要的诊断价值。
Objective To investigate the value of ST-T changes of ECG V4R lead in evaluating infarction-related coronary artery (IRA) in acute inferior myocardial infarction (AIMI) by comparing with coronary angiography (CAG). Methods The electrocardiogram and coronary angiography results of 82 patients with acute inferior myocardial infarction were compared and analyzed. The ST-T changes of V4R lead were divided into 3 types. Type Ⅰ: STV4R ↑ ≥1mm, T wave upright; Type Ⅱ: 0mm 1 in RCA group and RCAd group was significantly higher than that in LCX group (p <0.05) The incidence of standard in RCAp group was significantly higher than RCAd group and LCX group (p <0.05), the sensitivity was 87.0% and the specificity was 81.8%. The incidence of type II standard in RCAd group was significantly higher than that in RCAp group and LCX group Group (p <0.05). Those who met the criteria of type Ⅲ were significantly higher than those of RCAp and RCAd (p <0.05) in LCX group. Conclusion The characteristic changes of ST-T in V4R lead to acute inferior myocardial infarction have important diagnostic value for the location of infarct-related artery (IRA).