心电图aVR和V_1导联在左主干慢性病变中的诊断价值

目的探讨体表心电图aVR和V1导联特征性变化对左主干慢性病变的诊断价值。方法选取172例确诊心绞痛患者,其中左主干(LM)病变组64例,前降支(LAD)6#段病变组108例,对其心电图和冠状动脉造影资料进行对比分析。结果①LM组aVR导联ST段抬高幅度显著大于LAD组(0.068mV±0.075mV∶0.026mV±0.045mV)(P<0.01),抬高的比率显著大于LAD组(62.50%∶27.78%,P<0.01);aVR导联ST段抬高幅度与V1导联ST段抬高幅度差值(ST aVR↑～ST V1↑)>0的比率在两组间差异有显著性意义(50.00%∶13.89%,P<0.01);②aVR导联ST段抬高对左主干病变诊断的特异性72.22%,ST aVR↑～ST V1↑>0的诊断特异性86.11%。结论体表心电图中aVR导联ST段抬高、ST aVR↑～ST V1↑>0,可作为预测慢性左主干病变的指标。

The Diagnostic Value of aVR and V1 Lead in Chronic Left Main Coronary Artery Disease

Objective To investigate the value of aVR and V1 lead in the diagnoses of the left main coronary artery （LM） chronic occlusion or high stenosis . Methods The electrocardiogram and coronary angiographic findings were analyzed in 172 patients with angina, including 64 eases of LM occlusion and 108 cases of LAD occlusion. Results （1） Significantly higher ST segment elevation in lead aVR was observed in the LM group than in the LAD group 0.068 mV ±0.075 mV：0.026 mV ±0.045 mV,（ P 〈0.01）. The ratio of patients with ST segment elevation in lead aVR was significantly higher in the LM group than in the LAD group （62.50% ：27.78%, P 〈 0.01）. The ratio of patients with ST aVR ↑ - ST V↑ 〉 0 was significantly differentbetween the two groups（50.00% ： 13.89%, P 〈 0.01 ）. （2）In the LM group, the speficity of ST segment elevation in aVR lead is 72.22 %, the speficity of patients with ST aVR ↑ - ST Vi ↑〉 0 is 86.11%. Conclusion ST segment elevation in lead aVR and ST aVR ↑ - ST V1↑ 〉 0 is good indicators in predicting LM lesion.