遵义医科大学学报2026，Vol.49Issue(8)：870-876,7.
血管导联在急性冠脉综合征诊断上的应用价值
Diagnostic utility of ECG leads in acute coronary syndrome
摘要
Abstract
Objective To investigate the diagnostic utility of vessel-specific leads(VSLS)derived from standard 12-lead ECGs for patients with suspected acute coronary syndrome(ACS).Methods A retrospective analysis was conducted on the clinical data of 856 patients with suspected ACS admitted to the Affiliated Hospital of Zunyi Medical University between January 2008 and December 2023.All patients underwent coronary angiography(CAG)and were divided into a CAG-negative group(338 cases)and a CAG-positive group(518 cases)based on the results.The degree of ST-segment deviation,positive detection rates,and diagnostic efficacy were com-pared between VSLS and conventional 12-lead ECGs using our self-developed VSLS analysis software.Results In the CAG-positive group,the maximum ST-segment deviation amplitude recorded by the VSLS was significantly greater than that of the conventional ECG.The sensitivity,specificity,positive predictive value,and negative predictive value for diagnosing ACS were 50.4%,72.2%,73.5%,and 48.7%,respectively,for VSLS,com-pared with 38.0%,74.6%,69.6%,and 44.0%for conventional ECG.Except for a slightly lower specificity with VSLS,its performance was superior across all other diagnostic metrics.In the non-ST-segment elevation ACS(NSTE-ACS)subgroup,the sensitivity,specificity,positive predictive value,and negative predictive val-ues were 35.7%,70.9%,56.9%,and 50.6%for VSLS,versus 22.8%,73.8%,48.4%,and 47.1%for conventional ECG,again with the same pattern of VSLS outperforming conventional ECG except for a slightly lower specificity.In the ST-segment elevation myocardial infarction(STEMI)subgroup,VSLS demonstrated su-perior metrics across all parameters:sensitivity(75.1%vs63.7%),specificity(83.3%vs80.6%),positive predictive value(96.0%vs 94.6%),and negative predictive value(38.5%vs 29.3%).The VSLS showed a high detection rate for left anterior descending artery(LAD)lesions at77.2%,but its ability to differentiate be-tween right coronary artery(RCA)and left circumflex artery(LCX)lesions was limited.Conclusion The VSLS may amplify the magnitude of ST-segment deviation in ACS patients and significantly improve diagnostic sensitivi-ty,making it a valuable adjunctive tool for ACS diagnosis.However,its limited ability to precisely localize the culprit coronary artery lesion necessitates that it be interpreted in conjunction with comprehensive clinical data.关键词
急性冠脉综合征/心电图/血管导联/冠脉造影Key words
acute coronary syndrome/electrocardiogram/vessel-specific leads/coronary angiography分类
医药卫生引用本文复制引用
郭其凤,韩旭,梁丽娜,匡德俊,汤进..血管导联在急性冠脉综合征诊断上的应用价值[J].遵义医科大学学报,2026,49(8):870-876,7.基金项目
遵义市科技计划项目[NO:遵市科合HZ字(2023)311]. （2023）
