aVR导联ST段抬高对冠脉左主干和/或3支血管病变的诊断价值

张羽中; 张建义

doi:10.13308/j.issn.2095-9354.2016.05.005

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实用心电与临床诊疗 ›› 2016, Vol. 25 ›› Issue (5) : 322-327. DOI: 10.13308/j.issn.2095-9354.2016.05.005

专题笔谈-：心电图aVR导联临床应用

aVR导联ST段抬高对冠脉左主干和/或3支血管病变的诊断价值

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Diagnostic value of ST segment elevation in lead aVR for patients with left main coronary artery and (or)3 vessel disease

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摘要

严重的冠脉病变包括冠脉左主干（left main coronary artery，LMCA）急性完全闭塞、次全闭塞以及3支血管病变（3vessel disease，3vd）。尽管LMCA急性完全闭塞患者能生存到达医院者很少，但aVR导联ST段抬高对其诊断的特异性和准确率均超过80%。对LMCA急性次全闭塞及3vd患者，aVR导联ST段抬高的诊断价值高于心电图的任何其他单一或多个导联。aVR导联ST段抬高幅度越大、持续时间越长，患者的病情就越重。本文对aVR导联ST段抬高的诊断标准、电生理机制及国外研究进展进行综述。

Abstract

Severe coronary artery diseases include acute complete or subtotal occlusion of left main coronary artery(LMCA) and 3vessel disease(3vd). Although the patients with acute complete occlusion of LMCA rarely arrive to hospital alive, the specificity and accuracy rate of ST segment elevation in lead aVR are both above 80%. For the patients with acute subtotal occlusion of LMCA and 3 vd, its diagnostic value is higher than that of any other single lead or multiple ones. The higher the amplitude of ST segment elevation in lead aVR is and the longer the duration is, the more serious the patients condition is. This paper reviews the diagnostic criteria of ST segment elevation in lead aVR, electrophysiological mechanism and overseas research progress.

导出引用

张羽中, 张建义. aVR导联ST段抬高对冠脉左主干和/或3支血管病变的诊断价值[J]. 实用心电学杂志, 2016, 25(5): 322-327 https://doi.org/10.13308/j.issn.2095-9354.2016.05.005

ZHANG Yu-Zhong, ZHANG Jian-Yi. Diagnostic value of ST segment elevation in lead aVR for patients with left main coronary artery and (or)3 vessel disease[J]. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2016, 25(5): 322-327 https://doi.org/10.13308/j.issn.2095-9354.2016.05.005

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