活动平板运动试验avR导联ST段抬高对左冠状动脉病变的诊断价值  

The value of the ST-segment elevation in lead avR of treadmill exercise test in the diagnosis of left coronary artery lesions

作　　者：虞春宜[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院心电图室,湖北宜昌443003

出　　处：《蚌埠医学院学报》2017年第6期769-771,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨活动平板运动试验av R导联ST段抬高对左冠状动脉病变的诊断价值。方法:选择82例活动平板运动试验阳性的冠心病病人,根据是否伴有av R导联ST段抬高≥0.01 m V分为2组,其中ST段抬高组42例,无ST段抬高组40例,所有病人同时进行冠状动脉造影(CAG)。结果:ST段抬高组CAG阴性3例,阳性39例;无ST段抬高组CAG阴性4例,阳性36例。ST段抬高组左前降支近端发生率为58.97%,高于无ST段抬高组的33.33%(P<0.05);而左前降支远端病变发生率为5.13%,低于无ST段抬高组的50.00%(P<0.01)。ST段抬高组左主干、右冠状动脉和三支病变发生率与无ST段抬高组差异均无统计学意义(P>0.05)。avR导联ST段抬高组CAG阳性时对左主干病变阳性预测值为70.00%;如将左主干与左前降支近端合并,则阳性预测值为90.91%。结论:活动平板运动试验阳性并伴av R导联ST段抬高≥0.01 mV,对左冠状动脉病变有较高的诊断价值。Objective：To explore the value of the ST-segment elevation in lead avR of treadmill exercise test in the diagnosis of left coronary artery lesions.Methods：Eighty-two coronary artery disease patients with the positive treadmill exercise test were divided into the ST-segment elevation group（42 cases）and non-ST-segment elevation group（40 cases）according to the ST-segment elevation（≥0.01 mV）.The coronary angiography（CAG）in two groups was examined.Results：Three cases of negative CAG and 39 cases of positive CAG in ST-segment elevation group,and 4 cases of negative CAG and 36 cases of positive CAG in non-ST-segment elevation group were identified.The incidence rate of proximal left anterior lesion in ST-segment elevation group（58.97%）was higher than that in non-ST-segment elevation group（33.33%）（P〈0.05）,but the incidence rate of distal left anterior lesion in ST-segment elevation group（5.13%）was lower than that in non-ST-segment elevation group（50.00%）（P〈0. 01）.The differences of the incidence rates of left main branch,right coronary artery and three-branch lesions between two groups were not statistically significant（P〉0.05）.The positive predictive value of left main branch lesion was 70.00%under the condition of positive ST-elevation in lead avR,and the positive predictive value was 90.91%under the condition of combination of left main branch with proximal left anterior branch.Conclusions：The positive treadmill exercise test combined with ST-segment elevation≥0.01 mV in lead avR has high diagnostic values in left coronary artery lesions.

关 键 词：冠状动脉病变 活动平板运动试验 AVR导联 ST段抬高 

分 类 号：R541.1[医药卫生—心血管疾病]