下壁心肌梗死Rvs振幅降低及Rv4/Rv5比值对合并后壁心肌梗死定位诊断及梗死相关动脉研究(1)
【摘要】 目的 探讨Rv5较Rv4波幅降低幅度和Rv4/Rv5比值指标，分析下壁合并后壁心肌梗死诊断价值及梗死病变动脉相关性。方法 下后壁MI 270例(急性176例，陈旧性94例)，单纯下壁MI 408例，健康人100例，均查同步12导联ECG，确定Rv4较Rv5波幅降低≥0.5 mV及Rv4/Rv5≥1.5，对MI不同病程及冠脉造影相关动脉综合分析。结果 Rv4波幅各组间差异无统计学意义(P>0.05)，下后壁组Rv5降低0.40~0.49 mV 7例(2.6%)，≥0.5 mV 263例(97.3%)。Rv4/Rv5≥1.5，急性期与陈旧性差异无统计学意义(P>0.05)，但高于下壁和健康组(Pv5振幅较Rv4降低≥O.5 mV，Rv4/Rv5≥1.5与下后壁MI定位、病变范围累及梗死冠脉有关而与病程及时程无关。Rv5波幅降低越明显，Rv4/Rv5比值越大，对下壁合并后壁MI诊断率越高，为临床治疗STEAMI PCI和冠脉造影，开通梗死相关动脉提供依据。
【关键词】心肌梗死；冠状动脉造影；Rv5振幅；Rv4/Rv5
Study on below myocardial infarction with Rv5descend and Rv4/Rv5diagnose of the posterior myocardial infarction
WANG Feng.Department of Cardiovascular Internal Medicine， the Fifth Affiliated Hospital of Zhengzhou University 450052，China
【Abstract】 Objective To study diagnose with the below myocardial(BMI)on Rv5descend and Rv4/Rv5vatic of the posterior MI.Methods 270 cases of the BMI merge into PMI (AMI) 176 cases and 94 cases of QMI.408 cases of the BMI.216 cases of normal 12 lead ECG on Rv5in comparison with Rv4lower and Rv4/Rv5≥1.5，11 cases coronary artery form reflection of BMI.Results Rv4amplitude a Bout the same similar of between every group (Pv5amplitude lower 0.4-0.49 mV (2.6%) and ≥0.5 mV of 203 cases (97.1%).AMI and QMI of Rv5in comparison with Rv4lower ≥0.5 mV and Rv4/Rv5≥1.5 (P>0.05) into the susceptibility 97.1%，the excellent 82.9%，the accurate 90.4%，the positive 94.4%comparison with below and normal group high (Pv5compored with Rv4lower ≥0.5 mV and Rv4/Rv5≥1.5 of the fixed position to do with scope and have nothing to do with course disease BPMI. Rv5amplitude with the more over，Rv4/Rv5the more ratio of diagnose rate the more of BPMI.Coronary artery radiography prompts where two and three most raise of coronary armory cabalism.
【Key words】Myocardial infarction；Coronary armory radiography；Rv5；Rv4/Rv5
心肌梗死(MI)是严重心血管事件，下壁AMI常伴有后壁及右室受累，而采用12导联心电图，常易被漏诊或加做V7、V8、V9，翻身不便延误时间。本文前瞻性探讨胸前导联Rv5波幅较Rv4降低和Rv4/Rv5，比值与下壁合并后壁MI的相关性，并对梗死相关动脉进行研究。国内外少见类似报道[1]，旨在发挥简便、快捷ECG检测，准确评估下壁并后壁MI面积和梗死相关动脉及临床近期预后，对比观察及测定结果分析报告如下。
1 资料与方法
1.1 临床资料 选择1998年1月至2007年12月，均为本院心脏科住院患者下壁合并后壁MI(下后壁组)270例，男156例，女114例；年龄36~78岁，平均(53.9±8.7)岁。下壁MI(下壁组)408例，男239例，女169例；年龄32~81岁，平均(52.6±6.9)岁。正常组健康查体100例，男67例，女33例；年龄26~78岁，平均(50.9 4±8.1)岁。各组之间年龄、性别无明显差异，具有可比性。
1.2 诊断依据 678例MI患者均符合WHO制定的缺血性心脏病诊断标准，并有典型临床症状，ECG及心肌酶学改变，超声心动图，均经急诊皮冠状动脉造影(PCI)明确诊断。ECG除外下壁合并其他部位MI(前壁、侧壁)、束支传导阻滞、预激综合征。冠状动脉受累情况分病变至少1支主要冠状动脉或其主要分支有≥75%的狭窄，单支病变、双支病变、3支病变。病变按左前降支，左回旋支和右冠状动脉和左主干冠状动脉计算。
, 百拇医药(王 丰)
【关键词】心肌梗死；冠状动脉造影；Rv5振幅；Rv4/Rv5
Study on below myocardial infarction with Rv5descend and Rv4/Rv5diagnose of the posterior myocardial infarction
WANG Feng.Department of Cardiovascular Internal Medicine， the Fifth Affiliated Hospital of Zhengzhou University 450052，China
【Abstract】 Objective To study diagnose with the below myocardial(BMI)on Rv5descend and Rv4/Rv5vatic of the posterior MI.Methods 270 cases of the BMI merge into PMI (AMI) 176 cases and 94 cases of QMI.408 cases of the BMI.216 cases of normal 12 lead ECG on Rv5in comparison with Rv4lower and Rv4/Rv5≥1.5，11 cases coronary artery form reflection of BMI.Results Rv4amplitude a Bout the same similar of between every group (Pv5amplitude lower 0.4-0.49 mV (2.6%) and ≥0.5 mV of 203 cases (97.1%).AMI and QMI of Rv5in comparison with Rv4lower ≥0.5 mV and Rv4/Rv5≥1.5 (P>0.05) into the susceptibility 97.1%，the excellent 82.9%，the accurate 90.4%，the positive 94.4%comparison with below and normal group high (Pv5compored with Rv4lower ≥0.5 mV and Rv4/Rv5≥1.5 of the fixed position to do with scope and have nothing to do with course disease BPMI. Rv5amplitude with the more over，Rv4/Rv5the more ratio of diagnose rate the more of BPMI.Coronary artery radiography prompts where two and three most raise of coronary armory cabalism.
【Key words】Myocardial infarction；Coronary armory radiography；Rv5；Rv4/Rv5
心肌梗死(MI)是严重心血管事件，下壁AMI常伴有后壁及右室受累，而采用12导联心电图，常易被漏诊或加做V7、V8、V9，翻身不便延误时间。本文前瞻性探讨胸前导联Rv5波幅较Rv4降低和Rv4/Rv5，比值与下壁合并后壁MI的相关性，并对梗死相关动脉进行研究。国内外少见类似报道[1]，旨在发挥简便、快捷ECG检测，准确评估下壁并后壁MI面积和梗死相关动脉及临床近期预后，对比观察及测定结果分析报告如下。
1 资料与方法
1.1 临床资料 选择1998年1月至2007年12月，均为本院心脏科住院患者下壁合并后壁MI(下后壁组)270例，男156例，女114例；年龄36~78岁，平均(53.9±8.7)岁。下壁MI(下壁组)408例，男239例，女169例；年龄32~81岁，平均(52.6±6.9)岁。正常组健康查体100例，男67例，女33例；年龄26~78岁，平均(50.9 4±8.1)岁。各组之间年龄、性别无明显差异，具有可比性。
1.2 诊断依据 678例MI患者均符合WHO制定的缺血性心脏病诊断标准，并有典型临床症状，ECG及心肌酶学改变，超声心动图，均经急诊皮冠状动脉造影(PCI)明确诊断。ECG除外下壁合并其他部位MI(前壁、侧壁)、束支传导阻滞、预激综合征。冠状动脉受累情况分病变至少1支主要冠状动脉或其主要分支有≥75%的狭窄，单支病变、双支病变、3支病变。病变按左前降支，左回旋支和右冠状动脉和左主干冠状动脉计算。
, 百拇医药(王 丰)