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目的探讨非ST段抬高型急性冠脉综合征(NSTE-ACS)a VR导联ST(ST_(aVR))抬高及QRS波时限增宽对左主干或多支病变的预测价值。方法回顾性分析165例患者,与冠状动脉造影对比分析,探讨ST_(aVR)抬高(≥0.5mm)及QRS波宽度≥0.11s与左主干或多支病变的相关性。结果本组患者包括单支病变102例,左主干或多支病变63例。ST_(aVR)抬高及QRS时限增宽中,多支病变组发病率分别为82.54%、77.78%,单支病变组分别为17.65%、23.53%,两组间有统计学差异(p<0.001)。ST_(aVR)抬高及QRS波增宽对于预测左主干或多支病变的敏感性、特异性及准确性均较高,分别为82.53%、77.78%,83.35%、76.47%,以及82.42%、76.97%。结论综合STa VR抬高及QRS波宽度的改变,有助于NSTE-ACS患者左主干或多支病变的初步诊断。
Objective To investigate the predictive value of ST (ST_ (aVR) elevation and QRS duration extension in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) aVR for the prediction of left main or multi-vessel disease. Methods A retrospective analysis of 165 patients with coronary angiography contrast analysis of the ST_ (aVR) elevation (≥ 0.5mm) and QRS width ≥ 0.11s and left main or multi-vessel disease correlation. Results This group of patients, including 102 cases of single-vessel disease, left main or multi-vessel disease in 63 cases. The incidences of multi-vessel disease were 82.54% and 77.78% in STV (aVR) elevation and QRS duration, respectively, and those in single vessel disease group were 17.65% and 23.53%, respectively ). The sensitivity, specificity and accuracy of ST_ (aVR) elevation and QRS broadening were 82.53%, 77.78%, 83.35%, 76.47% and 82.42% respectively for predicting left main or multi-vessel disease, 76.97%. Conclusion The elevation of STa VR and the change of QRS width can be helpful for the primary diagnosis of left main or multi-vessel disease in patients with NSTE-ACS.