摘要
目的分析不同罪犯血管引起的急性下壁心肌梗死患者的临床特点。方法纳入发病12 h内入院的急性下壁心肌梗死患者268例,急诊行冠状动脉造影(CAG)检查,根据不同罪犯血管将患者分为2组,右冠状动脉(RCA)组:216例为闭RCA塞;左回旋支冠状动脉(LCX)组:52例为LCX闭塞。对两组临床特征和心电图进行比较分析。结果合并右室心肌梗死,心源性休克,RCA组心力衰竭显著高于LCX组(P<0.05);RCA组左室射血分数(LVEF)显著低于LCX组[(51±8)%vs.(58±10)%,P<0.05];但住院死亡率等两组比较差异无统计学意义(P>0.05);心电图STⅢ抬高/STⅡ抬高≥1、STV4R抬高≥1 mm、高度房室传导阻滞(AVB)、室速/室颤(VT/VF)各项指标在RCA组显著高于LCX组(P<0.01)。结论 RCA和LCX梗死引起的急性下壁心肌梗死临床特征和心电图表现有差异,心电图Ⅱ、Ⅲ及V4R导联ST段变化能预测急性下壁心肌梗死患者犯罪血管,对临床治疗和预后有指导作用。
Objective To analyze the clinical characteristics of inferior acute myocardial infarction （AMI） induced by different culprit vessels. Methods The patients （n=268） with inferior AMI attacked within 12 h were chosen and given emergency coronary angiography （CAG）, and divided, according to different culprit vessels, into RCA group （with RCA occlusion, n=216） and LCX group （with LCX occlusion, n=52）. The clinical characteristics and electrocardiogram （ECG） indexes were compared between 2 groups. Results The patients with right ventricular myocardial infarction, cardiac shock and heart failure were significantly more in RCA group than those in LCX group （P0.05）. The indexes of STⅢelevation/STⅡelevation≥1, STV4R elevation≥1 mm, AVB and VT/VF were all significantly higher in RCA group than those in LCX group （P〈0.01）. Conclusion Inferior AMI induced by RCA occlusion or LCX occlusion has different clinical characteristics and ECG expressions. The ST-segment changes of ECGⅡlead,Ⅲlead and V4R lead can predict culprit vessels in patients with inferior AMI, which has guide effect on clinical treatment and prognosis.
出处
《中国循证心血管医学杂志》
2015年第3期307-308,312,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
总参军事医学和老年病科研基金项目(课题编号:ZCWS14B01)
关键词
急性下壁心肌梗死
罪犯血管
Inferior acute myocardial infarction
Culprit vessels
