aVR 导联 ST 段抬高对冠脉左主干和／或3支血管病变的诊断价值

严重的冠脉病变包括冠脉左主干（left main coronary artery，LMCA）急性完全闭塞、次全闭塞以及3支血管病变（3-vessel disease，3-vd）。尽管 LMCA 急性完全闭塞患者能生存到达医院者很少，但 aVR 导联 ST 段抬高对其诊断的特异性和准确率均超过80％。对 LMCA 急性次全闭塞及3-vd 患者，aVR 导联 ST 段抬高的诊断价值高于心电图的任何其他单一或多个导联。aVR 导联 ST 段抬高幅度越大、持续时间越长，患者的病情就越重。本文对 aVR 导联 ST段抬高的诊断标准、电生理机制及国外研究进展进行综述。

Diagnostic value of ST segment elevation in lead aVR for patients with left main coronary ar-tery and (or)3-vessel disease

Severe coronary artery diseases include acute complete or subtotal occlusion of left main coronary artery(LMCA)and 3-vessel disease(3-vd).Although the patients with acute com-plete occlusion of LMCA rarely arrive to hospital alive,the specificity and accuracy rate of ST seg-ment elevation in lead aVR are both above 80%.For the patients with acute subtotal occlusion of LMCA and 3-vd,its diagnostic value is higher than that of any other single lead or multiple ones. The higher the amplitude of ST segment elevation in lead aVR is and the longer the duration is,the more serious the patient's condition is.This paper reviews the diagnostic criteria of ST segment ele-vation in lead aVR,electrophysiological mechanism and overseas research progress.