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目的 :前瞻性研究前壁急性心肌梗死 ( AMI)病人下壁 ST段压低的意义。方法 :连续评价前壁 AMI病人 ,选择病人就诊头 3h心电图 ( ECG)测量其 ST段水平 ,并于住院第 10～ 2 1天行冠状动脉造影 ( CAG) ,评估左冠前降支 ( L AD)梗塞相关病变与第一对角支 ( D1)开口的位置关系。结果 :入选 85例中 2例 CAG阴性。余 83例分两组 ,A组为 LAD病变在 D1开口前或 D1开口后但合并 D1病变 ( 63例 ) ,B组为 D1开口后但不合并 D1病变 ( 2 0例 )。83例中 、 、a VF导联 ST段压低≥ 1mm者分别为 2 7、38、38例。以 、a VF导联 ST段压低≥ 1mm预测 A组病变的阳性预测值分别为92 .1%和 89.5 % ( P <0 .0 5 )。结论 :前壁 AMI时下壁 ST段压低提示 LAD近端病变或 LAD远端病变合并 D1病变。
AIM: To prospectively study the significance of ST segment depression in the inferior wall of anterior wall acute myocardial infarction (AMI). Methods: The AMI patients in the anterior wall were evaluated continuously. The ST segment of the AMI patients were selected for the first 3 hours of treatment. The coronary artery angiography (CAG) was performed on the 10th to 21st day after hospitalization. The left anterior descending coronary artery ) Infarction-related lesions and the position of the first diagonal branch (D1) opening. Results: Two of 85 patients were negative for CAG. The other 83 cases were divided into two groups. Group A was LAD lesion before D1 opening or after D1 opening but with D1 lesion (63 cases), group D1 after D1 opening but without D1 lesion (20 cases). 83 cases, a VF lead ST segment depression ≥ 1mm were 27,38,38 cases. However, the predictive value of ST segment depression ≥ 1 mm in predicting VF in group A was 92.1% and 89.5% respectively (P <0.05). Conclusions: ST segment depression in the anterior wall of AMI suggests that the LAD proximal lesion or LAD distal lesion with D1 lesion.