十二导联心电图对左主干病变导致急性冠状动脉综合征的诊断价值

The Value of 12-Lead Electrocardiogram in the Diagnosis of Left Main Disease Leading with Acute Coronary Syndrome

目的探讨十二导联心电图对左主干病变导致急性冠状动脉综合征(ACS)的诊断价值。方法37例ACS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)17例和B组(左前降支近段病变导致ACS组)20例,2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组在Ⅱ、Ⅲ、aVF、V2、V3、V4、V5、V6导联上相应ST段压低的发生率高于B组(P<0.05或P<0.01)。A组ST段在aVR、V1导联抬高并aVF、V2、V4导联压低发生率高于B组(P<0.05)。结论十二导联心电图上aVR、V1导联ST段抬高并aVF、V2、V4导联压低对ACS患者左主干病变有较好的阳性预测价值。

Objective To explore the value of 12-lead electrocardiogram（ECG） in the diagnosis of left main disease leading with acute coronary syndrome （ACS）. Methods Thirty-sevsen patients with ACS who underwent coronary arteriongraphy due to left main disease（groupA,n： 17） or proximal left anterior descending disease（group B,n= 20）. They were accepted 12-lead ECG inspection when chest pain both group A and B, to analyze the relationship between the coresponding ST segment variation Of 12-lead ECG and coronary artery lesion. Results The incidence rate of corresponding ST segment depression in leads Ⅱ . Ⅲ. aVF. V2. V3, V4. Vs and V6 was higher in the group A than in the group B（P〈0.05 or P〈0.01）. The incidence rate of ST segment elevation in leads aVR and V1 and ST segment depression in leads aVF.V2 and V4 was higher in the group A than in the group B（P〈0.05）. Conclusion ST segment elevation in leads aVR and V1 and ST segment depression in leads aVF,V2 and V4 of 12-lead ECG are good positive predictive value in left main disease in patient with ACS.