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常规体表心电图是早期确诊急性冠状动脉综合症(ACS)的简便、有效、无创性检查手段,在冠心病的诊断和治疗方面具有临床指导作用。左主干(LM)及前降支(LAD)病变是冠心病当中的严重病变,尤其是左主干及前降支近段一旦闭塞常导致严重后果,危及生命,而由于常规18导联心电图系统的缺点,心肌梗死部位及罪犯血管的诊断定位主要依靠aVR导联以外的心电图导联。但近年来,国内外学者研究aVR、V_1导联ST段抬高或伴其他导联ST段广泛下移常常提示病人存在严重冠脉病变,尤其是在前壁心肌梗死时可能预示病人有严重的左主干病变、左前降支近段病变,预后较差。本文主要总结左主干及前降支近段病变时与aVR或V_1等导联变化的相关性。
Conventional surface ECG is a simple, effective and noninvasive means of early diagnosis of acute coronary syndrome (ACS), which has clinical guidance in the diagnosis and treatment of coronary heart disease. Left main (LM) and anterior descending artery (LAD) lesions are serious disease in coronary heart disease, especially in the proximal left anterior descending artery and the proximal segment often lead to serious consequences, life-threatening, but due to the conventional 18-lead ECG system Shortcomings, myocardial infarction and the location of the culprit vascular diagnostic lead rely mainly on aVR leads outside the ECG lead. However, in recent years, domestic and foreign scholars study aVR, V_1 lead ST segment elevation or other leads with ST segment extensive down often prompts patients with severe coronary artery disease, especially in anterior myocardial infarction may indicate that the patient has serious Left main lesion, near the left anterior descending artery lesions, the prognosis is poor. This article mainly summarizes the left main and proximal descending artery lesions with aVR or V_1 and other lead changes in the correlation.