摘要
Abstract
Objective To explore the diagnostic value of electrocardiogram(ECG)for left main coronary artery disease (LMCA-D)by analyzing the 1 2 lead ECG of acute myocardial infarction (AMI)patients.Methods A total of 4 91 4 patients were enrolled in our study who had been diag-nosed with AMI and undergone coronary arteriography(CAG).In stratified random sampling method and based on CAG results,the sample was divided into LMCA-D group and non-LMCA-D group. We recorded the general clinical data of the two groups and their ECGs in blind measurement.By comparison of ECGs between the two groups,we obtained LMCA-D predictors.Results Binary lo-gistic regression analysis indicated that ST-segment elevation in lead aVR≥0.05 mV(OR:8.1 60, P <0.05)was an independent predictor of LMCA-D.With a combination of the five noninvasive in-dices including ST-segment elevation in lead aVR≥0.05 mV,ST-segment depression in lead V4 ~V6 ,the quantity of leads with ST-segment depression≥5,low voltage in lead aVF,and QRS com-plex duration >1 00 ms,the diagnostic probability of LMCA-D increased from 25.1 9% to 69.24%. The five indicators identified LMCA-D with positive predictive values of 52.63%,32.73%, 26.39%,1 6.22% and 22.22%,respectively.Conclusion ECG is feasible for predicting LMCA-D in AMI patients and ST-segment elevation in lead aVR≥0.05 mV is quite a favorable ECG indi-cator.Combination of various indicators helps to improve the diagnostic value of ECG for LMCA-D.关键词
急性心肌梗死/左主干病变/12导联心电图/冠脉造影术Key words
acute myocardial infarction/left main coronary artery disease/12 lead electrocardio-分类
医药卫生
