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目的:通过冠脉造影探讨下壁心肌梗死时ST段改变与相关冠状动脉闭塞的关系。方法:冠脉造影观察60例下壁心肌梗死ST段改变与相关血管结果对比及分析。结果:下壁心肌梗死,其中下壁24例,下壁+后壁10例,下壁+右室壁16例,下壁+前壁10例,包括血管单支病变20例,双支病变24例,三支病变16例。右冠脉狭窄88.7%,左冠脉回旋支狭窄11.2%。ST段抬高,ST段抬高Ⅱ>Ⅲ,压低AVL>I,诊断右冠脉闭塞,敏感性、特异性分别为96%、93.5%。V4、V5导联ST段压低与Ⅱ、Ⅲ导联ST段抬高比值>0.5,诊断左冠脉回旋支闭塞,敏感性、特异性分别为83.9%、79.3%。ST段抬高AVL>I,ST段压低Ⅱ>Ⅲ,提示左冠脉回旋支闭塞,敏感性、特异性分别为50%、76%。结论:冠脉造影示下壁心肌梗死右冠状动脉闭塞,心电图ST段抬高Ⅱ>Ⅲ,ST段压低AVL>I;冠脉造影示左冠脉回旋支闭塞,心电图V4、V5导联ST段压低与Ⅱ、Ⅲ导联抬高比值>0.5,ST段抬高AVL>I,ST段压低Ⅱ>Ⅲ。
Objective: To investigate the relationship between ST segment changes and related coronary occlusion in patients with inferior myocardial infarction by coronary angiography. Methods: The coronary angiography in 60 cases of inferior wall myocardial infarction ST segment changes and related vascular results comparison and analysis. Results: The inferior myocardial infarction included 24 cases of inferior wall, 10 cases of inferior wall and posterior wall, 16 cases of inferior wall and right ventricular wall, 10 cases of inferior wall and anterior wall, including 20 cases of single vessel disease and 2 cases of double vessel disease Cases, three lesions in 16 cases. Right coronary stenosis 88.7%, left coronary artery stenosis 11.2%. ST segment elevation, ST segment elevation Ⅱ> Ⅲ, AVL> I, diagnosis of right coronary artery occlusion, the sensitivity and specificity were 96% and 93.5% respectively. The ratio of ST segment depression in V4 and V5 lead to ST segment elevation ratio in lead Ⅱ and Ⅲ was> 0.5. The sensitivity and specificity of diagnosing left circumflex artery occlusion were 83.9% and 79.3% respectively. ST segment elevation AVL> I, ST segment depression Ⅱ> Ⅲ, suggesting that the left coronary artery occlusion, sensitivity, specificity were 50%, 76%. CONCLUSION: Coronary angiography shows right coronary artery occlusion of inferior wall myocardial infarction, electrocardiogram ST segment elevation Ⅱ> Ⅲ, ST segment depression AVL> I; coronary angiography shows left coronary artery occlusion, ECG V4, V5 lead ST segment The ratio of depression to Ⅱ, Ⅲ lead elevation> 0.5, ST elevation AVL> I, ST depression Ⅱ> Ⅲ.