运动试验阳性患者aVR及V1导联ST段变化对左主干病变的预测价值  

Exercise-induced ST segment elevation in leads aVR and V1 for the prediction of left main coronary artery disease

作　　者：谢双伦[1] 王景峰[1] 聂如琼[1] 张晋康[1] 袁沃亮[1] 林永青[1] 

机构地区：[1]广州中山大学孙逸仙纪念医院心内科,510120

出　　处：《中华心律失常学杂志》2010年第3期216-218,共3页Chinese Journal of Cardiac Arrhythmias

基　　金：中山大学青年教师基金（2008001）

摘　　要：目的评价运动试验阳性（Duke评分≤-11分）患者中aVR及V1导联ST段变化对于左主干病变的预测价值。方法回顾性分析了96例（Duke评分≤-11分）运动试验阳性患者，在运动试验中aVR及V1导联ST段变化，并与冠状动脉造影（CAG）结果比较。结果单纯aVR导联ST段抬高，在诊断左主干病变的敏感性为85．5％，特异性47．t％，准确率62．5％；而aVR及V1导联ST段均抬高，且STaVB／STV1〉1时，在诊断左主干病变的敏感性为82．1％，特异性83．8％，准确率83．3％。结论在运动试验中aVR和V1导联ST段抬高（STaVa／STV1〉1），对左主干病变有较高的预测价值。Objective To evaluate the value of lead aVR and V1 on the exercise electrocardiogram for the detection of left main coronary artery disease （ LMCAS ） in patients with the positive EET result （ Duke scores≤ - 11 ）. Methods Ninty-six patients with Duke score ≤ - 11 were retrospectively screened for pres- ence of ST-segment elevation in lead aVR and lead V1. Coronary arteriography （CAG） results were compared among different groups. Results Twenty-eight out of 96 were diagnosed as LMCAS. 24 out of 60 with ST-segment elevation in lead aVR and 26 out of 34 with ST-segment elevation in lead aVR and V1 （ STav/STv1 〉 1 ） were found to have LMCAS. Isolated exercise-induced ST elevation in lead aVR had a sensitivity of 85.5, a specificity of 47. 1% and an accuracy of 62. 5% in predicting LMCAS; ST-segment elevation in lead aVR and V1 （ STavR/STvl 〉 1 ） had a sensitivity of 82. 1% , a specificity of 83.8% and an accuracy of 83.3% in predicting LMCAS. Conclusion ST-segment elevation in lead aVR and V1 （ STavR/STV1〉 1 ） criteria has a high value in predicting LMCAS.

关 键 词：左主干病变 运动试验 

分 类 号：R541.4[医药卫生—心血管疾病]