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目的探讨普通心电图(ECG)判断急性下壁心肌梗死(AIMI)相关血管的价值。方法根据冠状动脉造影(CAG)结果,将118例首发AIMI患者分为右冠状动脉(RCA)闭塞组(A组,83例)和左回旋支(LCX)闭塞组(B组,35例)。回顾性分析患者就诊2h内记录的18导联ECG。结果 A组:V4R导联ST段抬高的敏感度和特异度分别为7.23%和100.00%;Ⅰ导联ST段压低的敏感度和特异度分别为81.93%和85.71%;aVL导联ST段压低>Ⅰ导联的敏感度和特异度分别为73.49%和71.43%;Ⅱ导联ST段抬高<Ⅲ导联的敏感度和特异度分别为85.54%和80.00%。B组:Ⅰ导联ST段抬高的敏感度和特异度分别为20.00%和98.80%;Ⅱ导联ST段抬高≥Ⅲ导联的敏感度和特异度分别为80.00%和85.54%。结论普通ECG对预测AIMI相关血管有很高的临床应用价值。
Objective To investigate the value of common electrocardiogram (ECG) in judging blood vessels related to acute inferior myocardial infarction (AIMI). Methods According to the results of coronary angiography (CAG), 118 patients with primary AIMI were divided into three groups: the right coronary artery (RCA) occlusion group (group A, 83 cases) and the left circumflex artery occlusion group (group B, 35 cases). The 18-lead ECG recorded within 2 hours of treatment was retrospectively analyzed. Results The sensitivity and specificity of ST segment elevation in V4R lead were 7.23% and 100.00% respectively in group A; the sensitivity and specificity of ST lead depression in lead Ⅰ were 81.93% and 85.71% respectively; the ST segment of lead aVL The sensitivity and specificity of lead Ⅰ were 73.49% and 71.43% respectively. The sensitivities and specificities of leads Ⅱ were 85.54% and 80.00% respectively. Group B: The sensitivity and specificity of ST segment elevation in lead Ⅰ were 20.00% and 98.80% respectively; the sensitivity and specificity of lead Ⅱ in ST segment elevation ≥ Ⅲ lead were 80.00% and 85.54% respectively. Conclusion Common ECG has great clinical value in predicting AIMI related blood vessels.