急性下壁心肌梗死胸前导联ST段压低的临床意义.docVIP

急性下壁心肌梗死胸前导联ST段压低的临床意义 ? 6.JournalofClinicalandExperimental肘MVo1.8.No.12Dec.2009 急性下壁心肌梗死胸前导联ST段压低的临床意义 吴迪春(如皋市人民医院心内科江苏如皋226500) 【摘要】目的分析急性下壁心肌梗死伴胸前导联sT段压低的临床意义.方法选择84例急性下壁心肌梗死 患者常规心电图及24h动态心电图进行对照分析.结果急性下壁心肌梗死伴胸前导联sT段压低多于不伴胸前导联 sT段压低(Plt;0.01);下壁伴正后壁心肌梗死伴胸前导联sT段压低多于不伴胸前导联ST段压低(Plt;0.01);下壁伴 右心室心肌梗死与胸前导联sT段压低无明显关联(Plt;0.01);急性下壁心肌梗死伴胸前导联sT段压低者严重室性心 律失常与房室传导阻滞的发生率较不伴胸前导联sT段压低者高(Plt;0.01).结论急性下壁心肌梗死伴胸前导联sT 段压低往往提示梗死范围大或同时存在心肌缺血,冠脉病变广泛,心功能损害较严重,并且严重室性心律失常与房室传 导阻滞的发生率明显增高,心肌酶峰值明显增高临床预后较差. 【关键词】急性下壁心肌梗死心电图sT段压低24h动态心电图临床意义 ClinicalimplicationofprecordialSTsegmentdepressioninac31teinferiormyocardialinfar~ion.WUD—chun. DepartmentofCardiology. Rugao§Hospital,Rugao~angsu226500,China. 【Abstract】ObjectiveToanMy~clinicalimplicationofprecordialSTsegmentdepressioninacutei~eriormyocardialinfarction(AIMI). MethodsRoutineelectrocardiogramand24hoursdynamicelectrocardiogramwereanalyzedin84patientswithacuteinferiormyocardialinfarc— tion.ResultsThenumberofpatientswithchestleadSTsegmentdescentweremorethanthatofpatientswithoutchestleadSTsegmentdescentin patie~swithacuteinferiormyocardialinfarction(Plt;O.O1)andinpatientswithinferiorwallandposteriorwailacutemyocardialinfarction(P lt;0.01);however,therewasnosignificantdifferenceforchestleadSTsegmentdescentbetweenpatientswithorwithoutinferiorwallandfight ventricleacutemyocardialinfarction(Pgt;0.05).Incidenceofseriousventrieulararrhythmiaandauricular—ventrieularblockinpatientswi出 chestleadSTsegmentdescentwassignificantlyhisher(Plt;0.O1).ConduslonAcuteinferiormyocardialinfarctionwithchestleadSTsegment descentindicatesextensiveinfarctionand/ormyocardialischemia,andseverecoronarylesionsanddamageofcardiacfunction.Thepossibilityofthe occurrenceofseriousventriculararrhythmiaandauricular—ventricularblockisincreased.AcuteinferiormyocardialinfarctionwitllchestleadST segmentdescentisassociatedwithbadprognosis. 【Keywords】Acuteinferiormyocardialinfarction;Routineelectrocardiogram;STsegmentdescent;Dynamicelectrocardiogram;Climcalim— plication 急性下壁心肌梗死心电图(