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目的探讨心电图aVR导联ST段抬高对急性冠脉综合征患者远期预后的诊断价值。方法根据心电图有无aVR导联ST段抬高将878例急性冠脉综合征患者分为观察组和对照组。对比分析两组患者冠状动脉病变特点和一年内心血管事件发生率。结果对照组813例患者中,左主干病变10例、三支病变58例,一年内发生心血管事件21例。观察组65例患者中,左主干病60例、三支病变4例,一年内发生心血管事件9例。组间比较差异有统计学意义,p<0.05。aVR导联ST段诊断左主干病变的敏感性为92.3%,特异性为98.8%,阳性预测值为85.7%。结论心电图aVR导联ST段抬高对急性冠脉综合征患者左主干病变有较好的诊断价值,并对患者心血管事件发生率具有较高的预测价值。
Objective To investigate the value of aVR lead ST segment elevation in the diagnosis of long-term prognosis in patients with acute coronary syndrome. Methods According to the presence or absence of ECG aVR lead ST segment elevation 878 cases of acute coronary syndrome patients were divided into observation group and control group. The characteristics of coronary lesions and the incidence of cardiovascular events in one year were compared between the two groups. Results Among the 813 patients in the control group, there were 10 cases of left main disease and 58 cases of 3 lesions. There were 21 cases of cardiovascular events within one year. In the observation group of 65 patients, there were 60 cases of left main trunk disease, 4 cases of 3 lesions and 9 cases of cardiovascular events within one year. The difference between the groups was statistically significant, p <0.05. The sensitivity of the ST segment of aVR lead in the diagnosis of left main disease was 92.3%, the specificity was 98.8% and the positive predictive value was 85.7%. Conclusion ST-segment elevation of aVR leads of electrocardiogram has a good diagnostic value for left main coronary artery disease in patients with acute coronary syndrome, and has a high predictive value for the incidence of cardiovascular events in patients.