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目的通过与冠状动脉造影对比,研究aVR导联ST段改变的特征及对不稳定型心绞痛病变血管的判断价值。方法不稳定型心绞痛患者155例,其中单支病变83例、双支病变32例、3支病变27例、左主干病变13例,均于胸痛发作时记录心电图。结果胸痛时Ⅰ、Ⅱ、aVL、V3～V6导联ST段压低,aVR导联ST段抬高在3支和左主干病变组较显著。aVR导联ST段抬高诊断3支和左主干病变的敏感性(Se)、特异性(Sp)、符合率(CR)、阳性预测值(PPV)、阴性预测值(NPV)在两组分别为85.19%、84.62%、76.52%、76.52%、78.17%和77.34%、46.00%、28.95%、95.65%、97.78%。结论胸痛发作时心电图出现aVR导联ST段抬高和相对应导联ST段下降对判断3支或左主干病变有预测价值。
Objective To investigate the characteristics of ST segment changes in lead aVR and its diagnostic value in angiography of unstable angina pectoris by contrast with coronary angiography. Methods 155 cases of unstable angina pectoris patients, including 83 cases of single-vessel disease, double-vessel disease in 32 cases, 27 cases of 3 lesions, left main disease in 13 cases, were recorded in the onset of chest pain electrocardiogram. Results ST segment depression in leads Ⅰ, Ⅱ, aVL and V3 ~ V6 in chest pain and ST segment elevation in lead aVR were more significant in 3 and left main trunk lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ST segment elevation in the aVR lead and the left main stem were It is 85.19%, 84.62%, 76.52%, 76.52%, 78.17% and 77.34%, 46.00%, 28.95%, 95.65% and 97.78% respectively. Conclusions The ST segment elevation of lead aVR in electrocardiogram and the decrease of ST segment corresponding to leads in the onset of chest pain have predictive value for judging the three branches or the left main lesion.