aVR导联心电图对左冠状动脉病变的预测价值

目的探讨aVR导联心电图对左冠状动脉病变程度的预测价值。方法56例急性前壁心肌梗塞患者,分析其心电图aVR的改变情况及冠状造影结果。结果心电图出现aVR导联ST段抬高≥0.05 mV 26例,无明显变化30例,其中ST段抬高组左主干,左前降支近端病变率分别为23.1%、57.7%,较ST段无改变组3.39%、30.0%有显著差异（P〈0.05）,而前降支中远段病变率则远远低于ST段无改变组（3.8%、50%）,差异有非常显著性（P〈0.01）。结论aVR导联心电图对左冠状动脉病变严重程度有预测价值。

Value of aVR lead in predicting the left coronary artery lesion

Objective To investigate the value of aVR lead in predicting the severity of left coronary lesion. Methods Fifty-six cases of episode of acute myocardial infarction in anterior wall were divided into elevation group and no-drift group according to the ST segment changes of aVR lead. Their ST segment elevation of aVR lead and coronary angiography （CAG） results were analyzed. Results Twenty-six cases showed ≥ 0.05mV elevation in ST segment of aVR lead by ECG while the other 30 cases demonstrated no obvious change. Of the cases in the elevation group, the rates of pathologic change in ST segment left main and proximal end of the left anterior descending branch were respectively 23.1% and 57.7%. There were significant differences compared with those in the no-drift group （3.3%, 30% ） （p 〈 0.05 ）. The rates of pathologic change in middle and distal segments were far lower than those in the no-drift group （ 3.8%, 50% ） （ p 〈 0.01 ）. Conclusion The aVR lead of ECG in patients with acute anterior wall myocardial infarction can predict the severity of left coronary artery le- sion.