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    收稿日期: 20072 032 01 修回日期: 20072 062 14

    (本文编辑:郭 宪 )

    ST段抬高急性心肌梗死的梗死相关动脉临床心电图诊断

    李一德1

    综述 姜德谦2

    审校

    (1 .湖南省益阳市中心医院心内科, 湖南 益阳 413000; 2 .中南大学湘雅附二医院心内科 , 湖南 长沙

    410011)

    Cli n i ca l Electrocardi ographi c D i agnosis of I nfarcti on2Rel a ted

    Artery i n Acute ST2 Eleva tedMyocardi a l I nfarcti on

    L I Yi2 de, J I ANG De2 qian

    (1 . Depart m ent of Cardiology, Central Hospital of Yiyang City, Yiyang 413000, China; 2 . Depart m ent of Cardiology, The Second Aff ili2

    ated Hospital of X iangya M edical College, Central South University, Changsha’ 410011, China)

    文章编号: 10042 3934 (2008) 012 01122 05 中图分类号: R540 . 4

    1; R542 . 2 文献标识码:A

    摘要: 急性心肌梗死是指因持续而严重的心肌缺血所致的部分心肌急性坏死。了解梗死相关动脉对急性心肌梗死的诊断起

    了决定性的作用。临床诊断冠脉病变常运用冠脉造影的方法 ,需要昂贵的设备和有一定条件的医院才能够做到。而使用心电图诊

    断 ST段抬高急性心肌梗死的梗死相关动脉临床简单、 易行。最近有不少研究都证明了该方法是可行的 ,现就此作一综述。

    关键词: 急性心肌梗死;心电图;梗死相关动脉

    Abstract: Acute myocardial infarcti on (AM I ) is caused by continuous and severe myocardial ischemia . I dentifying the infarcti on re2

    lated artery ( I RA) is crucial t o the diagnosis ofAM I . Clinically, the diagnosis of the cul p rit artery is established by coronary arteri ography,which needs expensive equi pment and s pecific qualificati ons . Diagnosing the I RA by electrocardi ogram is si mp le and convenient . Its feasibil2

    ity has been demonstrated by recent research, which is reviewed in this article .

    Key words: acute myocardial infarcti on; electrocardi ogram; infarcti on related artery

    自从冠脉介入技术的开展以来 ,人们就不断的探

    索心电图和冠脉造影间的联系。既往资料表明 ,因急

    性心肌梗死入院的病人中最常见的罪犯血管是左前降

    支 (LAD)占 44%～45%,其次为右冠状动脉 (RCA)占

    27%～39%和左旋支 (LCX)占 17%[ 1 ]。早期的研究

    仅限于用传统的心肌梗死部位分型来诊断梗死相关动

    脉 ,对于 LCX与 RCA病变的预测准确性欠佳[ 1 ]。随

    着研究的深入 ,人们也逐渐提高了运用心电图的某些

    特征改变预测梗死相关动脉的准确性。现对目前较新

    和研究较广的预测方法及公式作一介绍 ,以期使读者

    了解各种方法的优劣 ......