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在PTCA中充盈球囊,可短暂阻断冠脉血流,导致该支冠脉供血区心肌缺血。115例患者的145支冠脉施行PTCA。术中记录体表心电图,检测心肌缺血(J点后60ms处ST段压低≥0.lmV)。扩张左前降支时选用I和aVL导联,扩张左回旋支对选用I和aVL导联,扩张右冠脉时选用III和aVF导联,作为标准肢导联。球囊扩张30秒钟,12导联心电图对心肌缺血的总检出率高于标准肢导联(130/145对61/145,即90％对42％,P≤0.001)。就各支冠脉而言,12导联心电图对左前降支和左回旋支供血区心肌缺血的检出率高于标准肢导联(35/43对11/43,即81％对26％,P≤0.001;59/62对25/62,即95％对40％,P≤0.001),对右冠脉供血区
In the filling of PTCA balloon, can temporarily block the coronary blood flow, leading to coronary artery blood supply myocardial ischemia. 145 patients in 115 patients underwent PTCA. Intraoperative recording of surface ECG, myocardial ischemia (J point after 60ms ST segment depression ≥ 0.lmV). I and aVL leads were used in the expansion of the left anterior descending branch. I and aVL leads were used in dilatation of the left circumflex artery. III and aVF leads were used in the expansion of the right coronary artery as the lead of the standard limbs. After balloon dilatation for 30 seconds, the 12-lead ECG showed a higher overall rate of detection of myocardial ischemia than the standard lead (130/145 vs 61/145, 90% vs 42%, P ≦ 0.001). For each coronary artery, the 12-lead electrocardiogram showed a higher detection rate of myocardial ischemia in the left anterior descending branch and the left circumflex coronary artery than in the standard limb leads (35/43 vs. 11/43, 81% vs 26% , P≤0.001; 59/62 vs 25/62, ie, 95% vs 40%, P≤0.001), right coronary artery blood supply