[摘要] 目的 评价心电图对急性下壁心肌梗死(IAMI)患者梗死相关血管判断的临床意义。方法 选择2002年1月~2005年12月IAMI患者150例，对其心电图及冠状动脉造影资料进行回顾性分析。结果 150例中，右冠状动脉(RCA)为梗死相关血管(IRA)者115例(76.7%)，左回旋支(LCX)为35例(23.3%)，STⅢ/STⅡ抬高比值>1、STV4R抬高≥0.5 mm、STaVL>STⅠ压低提示RCA为IRA；而STⅢ/STⅡ抬高比值<1、STⅠ抬高提示LCX为IRA。结论 心电图中STⅢ/STⅡ抬高比值、STaVL、STⅠ及STV4R变化可作为IAMI患者梗死相关血管的临床判断指标。

    [关键词] 心肌梗塞；冠状动脉硬化；心电描记术

    Diagnostic value of electrocardiography in vessel responsible for inferior wall acute myocardial infarction

    LI Jie,HUI Yong-ming.Department of Cardiology,Fengtai Hospital,Beijing 100071,China

    [Abstract] Objective To evaluate the clinical significance of electrocardiography(ECG) criteria for the identification of the myocardial infarct-related artery (IRA) in inferior wall acute myocardial infarction(IAMI).Methods We retrospectively analyzed 150 patients with IAMI hospitalized between January 2002 to December 2005.Results There were 115(76.7%) patients whose IRA were right coronary artery (RCA) and 35(23.3%) patients whose IRA were left circumflex artery (LCX) among the 150 patients.ST-segment elevation in lead Ⅲ exceeding that in leadⅡ,ST-segment elevation≥0.5 mm in lead V4R,ST-segment depression in lead aVL exceeding that in leadⅠindicated that IRA were RCA;elevation of ST-segment Ⅲ<Ⅱ or ST-segment elevation in lead Ⅰ,implied that IRA were LCX.Conclusion ECG criteria such as the ratio of ST-segment elevation Ⅲ/Ⅱ,ST-segment depression in lead aVL and Ⅰ,ST-segment elevation in lead V4R and Ⅰcan be used for identifying IRA in patients with IAMI. ......