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目的探讨急性下壁心肌梗死(inferior wall myocardial infarction,IWMI)伴或不伴右心室心肌梗死(right ventricular myocardial infarction,RVMI)患者的心电图特征。方法选择发病12 h内入院的IWMI 268例,进行冠状动脉造影(coronary angiography,CAG)检查,以右冠状动脉(right coronary artery,RCA)右室支近端闭塞作为RVMI的诊断依据,将患者分为IWMI合并RVMI组(93例,RVMI组)和单纯IWMI组(175例,对照组),在安静休息状态下描记l8导联心电图,分析两组的心电图特征。结果 RVMI组STⅢ↑/STⅡ↑≥1、STV4R↑≥1 mm、电轴左偏、高度房室及右束支传导阻滞、心房颤动各项指标检出率均较对照组高,差异具有显著性(P<0.05)。结论 IWMI时心电图出现STⅢ↑/STⅡ↑≥1、STV4R↑≥1 mm、电轴左偏、高度房室及右束支传导阻滞、心房颤动高度提示IWMI合并RVMI,可作为诊断RVMI参考指征。
Objective To investigate the ECG characteristics of patients with acute inferior myocardial infarction (IWMI) with or without right ventricular myocardial infarction (RVMI). Methods A total of 268 IWMI patients admitted within 12 hours of onset were enrolled in this study. Coronary angiography (CAG) was performed. The proximal right occlusion of the right coronary artery (RCA) was used as the diagnostic basis of RVMI. IWMI combined RVMI group (93 cases, RVMI group) and simple IWMI group (175 cases, control group), in a quiet resting state l8 lead ECG, ECG characteristics of the two groups were analyzed. Results RVMI group ST Ⅲ ↑ / ST Ⅱ ↑ ≥1, STV4R ↑ ≥1 mm, the left axis of the axis, atrioventricular and right bundle branch block, the detection rate of atrial fibrillation indicators were higher than the control group, the difference was significant (P <0.05). Conclusions IWMI ECG with ST Ⅲ ↑ / ST Ⅱ ↑ ≥1, STV4R ↑ ≥1 mm, axial left deviation, atrioventricular and right bundle branch block, and atrial fibrillation highly suggest that IWMI combined with RVMI can be used as a reference for diagnosis of RVMI .