下壁心肌梗死Rvs振幅降低及Rv4Rv5比值对合并后壁心肌梗死定位诊断及梗死相关动脉的研究.docVIP

下壁心肌梗死Rvs振幅降低及Rv4Rv5比值对合并后壁心肌梗死定位诊断及梗死相关动脉的研究 　　【摘要】 目的 探讨Rv5较Rv4波幅降低幅度和Rv4/Rv5比值指标，分析下壁合并后壁心肌梗死诊断价值及梗死病变动脉相关性。方法 下后壁MI 270例（急性176例，陈旧性94例)，单纯下壁MI 408例，健康人100例，均查同步12导联ECG，确定Rv4较Rv5波幅降低≥0．5 mV及Rv4/Rv5≥1．5，对MI不同病程及冠脉造影相关动脉综合分析。结果 Rv4波幅各组间差异无统计学意义(P0．05)，下后壁组Rv5降低0．40~0．49 mV 7例(2．6%)，≥0．5 mV 263例(97．3%)。Rv4/Rv5≥1．5，急性期与陈旧性差异无统计学意义(P0．05)，但高于下壁和健康组(Pv5振幅较Rv4降低≥O.5 mV，Rv4/Rv5≥1．5与下后壁MI定位、病变范围累及梗死冠脉有关而与病程及时程无关。Rv5波幅降低越明显，Rv4/Rv5比值越大，对下壁合并后壁MI诊断率越高，为临床治疗STEAMI PCI和冠脉造影，开通梗死相关动脉提供依据。? 　　【关键词】心肌梗死；冠状动脉造影；Rv5振幅；Rv4/Rv5 　　 　　 　　Study on below myocardial infarction with Rv5descend and Rv4/Rv5diagnose of the posterior myocardial infarction 　　 　　WANG Feng.Department of Cardiovascular Internal Medicine， the Fifth Affiliated Hospital of Zhengzhou University 450052，China 　　? 　　【Abstract】 Objective To study diagnose with the below myocardial(BMI)on Rv5descend and Rv4/Rv5vatic of the posterior MI．Methods 270 cases of the BMI merge into PMI (AMI) 176 cases and 94 cases of QMI．408 cases of the BMI．216 cases of normal 12 lead ECG on Rv5in comparison with Rv4lower and Rv4/Rv5≥1．5，11 cases coronary artery form reflection of BMI．Results Rv4amplitude a Bout the same similar of between every group (Pv5amplitude lower 0．4-0．49 mV (2．6%) and ≥0．5 mV of 203 cases (97．1%)．AMI and QMI of Rv5in comparison with Rv4lower ≥0．5 mV and Rv4/Rv5≥1．5 (P0．05) into the susceptibility 97．1%，the excellent 82．9%，the accurate 90．4%，the positive 94．4%comparison with below and normal group high (Pv5compored with Rv4lower ≥0．5 mV and Rv4/Rv5≥1．5 of the fixed position to do with scope and have nothing to do with course disease BPMI． Rv5amplitude with the more over，Rv4/Rv5the more ratio of diagnose rate the more of BPMI．Coronary artery radiography prompts where two and three most raise of coronary armory cabalism．? 　　【Key words】Myocardial infarction；Coronary armory radiography；Rv5；Rv4/Rv5 　　 　　心肌梗死(MI)是严重心血管事件，下壁AMI常伴有后壁及右室受累，而采用12导联心电图，常易被漏诊或加做V7、V8、V9，翻身不便延误时间。本文前瞻性探讨胸前导联Rv5波幅较Rv4降低和Rv4/Rv5，比值与下壁合并后壁