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目的:探讨根据体表心电图的改变来判断急性下壁心肌梗死(AIMI)相关动脉的价值。方法:按照冠状动脉造影结果将70例急性下壁心肌梗死患者分为右冠状动脉(RCA)组(51例)和冠状动脉左回旋支(LCX)组(19例),比较两组患者心电图的改变。结果:右冠状动脉(RCA)组患者导联AVL的ST波段压低≥1mm的发生率明显高于冠状动脉左旋支(LCX)组患者(91%vs10%,P<0.01)。导联I的ST段压低≥1mm发生率也高于冠状动脉左旋支组,但是差异无统计学意义(24%vs15%,P>0.05)。右冠状动脉组患者导联AVL的QRS波群R/S之间的比值明显低于冠状动脉左旋支组(2.7±0.4vs3.4±0.5,P<0.01),导联I的R与S之间比值两组间比较差异无统计学意义(3.3±0.7vs3.54±0.9,P>0.05)。结论:AVL导联ST段的压低和R/S比值缩小是判断急性下壁心肌梗死(AIMI)动脉为右冠状动脉的良好指标。
Objective: To investigate the value of determining the artery related to acute inferior myocardial infarction (AIMI) based on the changes of body surface electrocardiogram. Methods: Seventy patients with acute inferior myocardial infarction were divided into RCA group (n = 51) and LCX group (n = 19) according to coronary angiography results. Electrocardiogram change. Results: The incidence of ST wave banding ≥1 mm in lead AVL was significantly higher in patients with right coronary artery (RCA) than in LCX patients (91% vs 10%, P <0.01). The incidence of ST segment depression ≥1 mm in lead I was also higher than that in left circumflex coronary artery group, but the difference was not statistically significant (24% vs 15%, P> 0.05). The R / S ratio of QRS complex in lead AVL of patients in right coronary artery group was significantly lower than that of left coronary artery in coronary artery (2.7 ± 0.4 vs 3.4 ± 0.5, P <0.01) There was no significant difference between the two groups (3.3 ± 0.7 vs 3.54 ± 0.9, P> 0.05). Conclusion: The reduction of ST segment and R / S ratio in AVL leads are good indicators for judging right coronary artery in acute inferior myocardial infarction (AIMI).