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慢性冠状动脉供血不足的体表标准12导联心电图(ST-T改变)对冠状动脉疾病诊断是无价值的,属于一种推测性、主观的判断。心电图存在持续性ST-T改变时,多数由其他因素引起的。对于前壁AM I患者,用avR导联ST段抬高大于等于V1导联ST段抬高的指标,可以鉴别是LM还是LAD的闭塞。对下壁AM I患者,用ST V3Ⅲ值既可以对RCA闭塞定位,又可区别出IRA是RCA还是LCX。另外,Ⅰ、avL导联ST段变化也可以作为鉴别RCA和LCX闭塞的指标。高侧壁AM I患者IRA的定位,主要根据它合并哪个壁的梗死。后间壁AM I心电图诊断标准为:①下壁AM I时伴V1导联ST段明显抬高≥2mm;②ST段抬高的幅度呈V1>V2>V3和V1>V3R>V4R。
Chronic coronary arterial insufficiency of the body surface standard 12-lead ECG (ST-T changes) is of no value in the diagnosis of coronary artery disease, is a speculative, subjective judgments. ECG changes in the presence of persistent ST-T, the majority of other factors. For patients with AM I in the anterior wall, ST-segment elevation in the avR leads is greater than or equal to the ST-segment elevation in the lead V1 and is an indication of LM or LAD occlusion. For patients with inferior AMI, ST V3 III values both RCA occlusion and IRA RCA or LCX. In addition, Ⅰ, avL lead ST segment changes can also be used as an indicator of RCA and LCX occlusion. The location of the IRA in patients with high-sidewall AM I is mainly based on which wall it merges with infarction. The posterior wall AM I ECG diagnostic criteria were: ① inferior wall AM I with V1 lead ST segment was significantly elevated ≥ 2mm; ② ST segment elevation range V1> V2> V3 and V1> V3R> V4R.