胸痛发作时心电图对左主干病变的诊断价值

目的探讨胸痛发作时心电图avR导联、V1导联ST段改变对诊断左主干病变的阳性预测价值。方法 61例急性冠脉综合征(ACS)组患者根据冠状动脉造影结果分为A组(左主干病变导致ACS组)35例和B组(左前降支近段病变导致ACS组)26例,两组患者胸痛发作时均行十二导联心电图检查,分析冠状动脉病变血管与相应心电图变化的关系。结果 A组ST段在avR导联、V1导联均抬高,且avR导联/V1导联ST段抬高>1,发生率高于B组(P<0.05);35例左主干病变患者中24例胸痛发作时心电图表现为avR导联、V1导联ST段抬高且avR导联ST段抬高>V1导联ST段抬高,敏感性68.5%。结论胸痛发作时avR导联、V1导联等ST段抬高并ST段抬高avR导联/V1导联>1,对ACS患者左主干病变的早期诊断有预测价值。

ECG for the diagnosis value of left main disease when chest pain happens

Objective To investigate the positive predictive value of left main disease through the changes of ST segment in the avR and V1 lead of ECG when chest pain happens.Methods 61 patients with ACS who underwent coronary arteriongraphy due to left main disease(group A,n=35) or proximal left anterior descending disease(group B,n=26).They were accepted 12-lead ECG inspection when chese pain happys to analy the relationship between the corosponding Stgment variation of 12-lead ECG and coronary arlery lesion.Results The incidence rale of corresponding Stgment depression elevation in leads avR and V1 and the level of ST stgment elevation avR/v1>1 was higher in the group A than in the group B(P <0.05).Conclusions ST stgment elevation in leands avRand V1 and the level of ST segment) avR/V1>1 are good predicitive value in left main disease in patient with ACS.