aVR导联ST抬高对急性非ST段抬高型心肌梗死者左主干或三支血管病变的预测

Effect of Elevation in Lead aVR for Left Main or 3-Vessal Disease in Patients with Non-ST Segment Elevation Acute Coronary Syndrome

目的研究急性非ST段抬高型心肌梗死(NSTE-AMI)者aVR导联抬高幅度,与冠状动脉造影(CAG)对比,判断其对左主干/三支病变(LM/3VD)诊断的指导作用。方法对比106例aVR导联ST段抬高程度,结合CAG结果,研讨诊断LM/3VD的敏感性、特异性及相关性。结果 aVR导联ST段抬高是LM/3VD的独立预测因子(P<0.01),aVR导联ST段抬高≥0.5mm预测LM/3VD的敏感性及特异性分别为76%、86%。ST段抬高≥1.0mm预测LM/3VD的敏感性及特异性分别为43%、96%,ST段抬高≥1.5mm预测LM/3VD的敏感性及特异性分别为18%、99%。结论 aVR导联ST段抬高是NSTE-AMI者LM/3VD非常有用的预测因子,特异性好。

Objective To investigate effect of elevation in lead aVR for Left Main or 3-Vessal Disease(LM/3VD) in patients with Non-ST Segment Elevation Acute Coronary Syndrome(NSTE-ACS) by Comparing with Coronary angiography(CAG). Methods On admission,the clinical factors of 106 patients,who underwent coronary angiography,ware evaluated.The elevation in lead aVR were measured on 12-lead electrocardiogram,by which to to evaluate sensitivity,specificity and dependability in identifying LM/3VD. Results Elevation in lead aVR was independent predictors of LM/3VD,A ST-segment elevation in lead aVR of ≥0.5mm identified LM/3VD with sensitivity of 76%,specificity of 86%.A ST-segment elevation in lead aVR of ≥1.0mm identified LM/3VD with sensitivity of 43%,specificity of 96%,and A ST-segment elevation in lead aVR of ≥1.5mm identified LM/3VD with sensitivity of 18%,specificity of 99%. Conclusion ST-segment elevation in lead aVR is very useful independent predictors of LM/3VD in patients with Non-ST Segment Elevation Acute Coronary Syndromes.