aVR导联ST段改变对不同冠脉血管病变的诊断及鉴别诊断意义  

The significance of lead aVR ST segment changes in the diagnosis and differential diagnosis of different coronary artery diseases

作　　者：张建义[1] 张羽中 

机构地区：[1]桂林医学院附属医院心内科,广西桂林541001 [2]桂林医学院第二附属医院心内科,广西桂林541199

出　　处：《实用心电学杂志》2016年第5期328-333,共6页Journal of Practical Electrocardiology

摘　　要：冠状动脉左主干及其主要分支病变均可引起心电图aVR导联ST段的抬高或压低,但不同血管病变所致心肌缺血或梗死的危险分层及临床预后却相差甚远,因此对不同冠脉血管病变的诊断及鉴别诊断非常重要。这其中aVR导联ST段的改变具有重要的临床意义,其诊断及鉴别诊断价值高于其他任何单一或多个导联。本文就aVR导联ST段的抬高或压低对不同冠脉血管病变的诊断及鉴别诊断意义、诊断标准及国外近年来的研究进展进行综述。The elevation and depression of lead aVR ST segment in electrocardiogram may result from left main coronary artery（ LMCA） or its major branches diseases.However,the risk stratification and clinical prognosis of myocardial ischemia or myocardial infarction due to different vascular lesions are rather different from each other.Therefore,it is important to make diagnosis and differential diagnosis of different coronary artery diseases.The changes of ST segment in lead aVR have important clinical significance,the diagnostic and differential diagnostic values of which are higher than any other single lead or multiple leads.This paper reviews on the diagnostic and differential diagnostic significance of the elevation and depression of lead aVR ST segment for different coronary artery diseases,diagnostic criteria and the latest overseas research progress in recent years.

关 键 词：心电图 AVR导联 冠状动脉左主干病变 3支血管病变 前壁心肌梗死 下壁心肌梗死 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]