Objective To investigate the relationship between the ratio of ST segment changes and infarct-re-lated artery in acute inferior myocardial infarction. Methods The ratio of ECG I, H, HI, aVL ,V3ST ST segment changes in 87 cases with acute inferior myocardial infarction was analyzed, then compared with coronary angiogra-phy. Results There were 70 cases with infarct-related artery (IRA) were the right coronary artery (RCA) (80.5%), and 17 cases were left coronary circumflex artery (LCX) (19.5%). ST ↑ HI/ST ↑ H > 1,ST ↓ aVL/ST ↓ I >1,ST ↓ V3/ ST ↑ III ≤ 1 -2 prompts IRA as RCA, with higher sensitivity and specificity, and the highest positive predictive value (PPV); ST ↑ III /ST ↑ II ≤1, ST ↓ aVL/ST ↓ I ≤ 1 ,ST 1 V3/ ST T III > 1.2 prompts IRA to LCX, with higher negative predictive value (NPV), the difference was statistically significant (P<0.01). Conclusion RCA is the main infarct-related artery in acute inferior myocardial infarction, and the radio of ST segment changes can predict infarction-related artery in acute inferior myocardial.%目的 探讨急性下壁心肌梗死(AMI)时心电图ST段改变对梗死相关动脉(IRA)的判断价值.方法 通过对87例急性下壁心肌梗死患者的心电图Ⅰ、Ⅱ、Ⅲ、aVL、V3导联ST段改变的比值进行分析,与冠状动脉造影结果对比.结果 (1)IRA为右冠状动脉(RCA)70例(80.5％),左冠状动脉回旋支(LCX)17例(19.5％)；(2) ST ↑Ⅲ/ST ↑Ⅱ＞1、ST↓ aVL/ST↓ Ⅰ＞1、ST↓V3/ ST ↑Ⅲ≤1.2提示IRA为RCA,其敏感性、特异性均较高,阳性预测值(PPV)最高；ST↑Ⅲ/ST↑Ⅱ≤1、ST↓aVL/ST↓ Ⅰ≤1、ST ↓ V3/ ST↑Ⅲ＞1.2提示IRA为LCX,其阴性预测值(NPV)均较高,两组差异具有统计意义(P＜0.01).结论 急性下壁心肌梗死时,RCA为主要梗死相关动脉,ST段改变的比值对急性下壁心肌梗死时的相关动脉有预测价值.
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