aVR导联对非ST段抬高型急性冠脉综合征冠状动脉病变的预测价值简

目的 通过与冠状动脉造影对比,研究aVR导联ST段改变的特征对非ST段抬高型急性冠脉综合征病变血管的预测价值.方法 分析625例非ST段抬高型急性冠脉综合征患者一般资料、心电图、超声心动图及冠状动脉造影结果.结果 aVR导联无ST段抬高组（n=537）、ST段抬高0.05～0.1 mrn组（n=58）、ST段抬高＞0.1 mm组（n=30）的左心室射血分数分别为53.6％±7.2％、50.2％±6.8％、48.2％±6.4％,3组比较差异有统计学意义（P=0.003）;恶性心律失常（室性心动过速或心室颤动）发生率分别为3.4％、8.6％、13.3％,3组比较差异有统计学意义（P=0.008）;病死率分别为2.2％、5.2％、10％,3组比较差异有统计学意义（P=0.026）;左主干和（或）三支病变的发生率分别为24.8％、37.9％、56.7％,3组比较差异有统计学意义（P＜0.0005）.结论 非ST段抬高型急性冠脉综合征患者出现aVR导联ST段抬高对判断左主干或三支病变有预测价值,应引起高度重视.

Value of lead aVR in diagnosing the severity of coronary artery lesion in non-ST-elevation acute coronary syndrome

Objectives To assess the value of lead aVR in diagnosing the severity of coronary artery disease in non-ST-elevation acute coronary syndrome （ACS） compared with coronary angiographic outcome.Methods General information,electrocardiogram,color doppler echocardiography and coronary angiographic outcomes of 625 cases with non-ST-elevation ACS were analyzed.Results Among 625 patients with non-ST-elevation ACS,537 had no ST-elevation in aVR,58 had minor （0.05-0.1 mm） ST-elevation in aVR and 30 had major （＞0.1 mm） ST-elevation in aVR,their left ventricular ejection fraction （LVEF） were 53.6％ ±7.2％,50.2％±6.8％ and 48.2％ ±6.4％,respectively （P=0.003） ;malignant arrhythmia （ventricular tachycardia or ventricular fibrillation） rates were 3.4％,8.6％ and 13.3％,respectively （P=0.008） ; mortality rates were 2.2％,5.2％ and 10％,respectively （P=0.026） ; incidences of left main and （or） three-vessel disease （LM/3-vd） were 24.8％,37.9％ and 56.7％,respectively （P＜0.0005）.Conclusions ST-elevation in aVR can be useful in the early identification of LM/3-vd in patients with non-ST-elevation ACS,and it should be highly valued.