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中文摘要：
目的评价运动试验阳性（Duke评分≤-11分）患者中aVR及V1导联ST段变化对于左主干病变的预测价值。方法回顾性分析了96例（Duke评分≤-11分）运动试验阳性患者，在运动试验中aVR及V1导联ST段变化，并与冠状动脉造影（CAG）结果比较。结果单纯aVR导联ST段抬高，在诊断左主干病变的敏感性为85．5％，特异性47．t％，准确率62．5％；而aVR及V1导联ST段均抬高，且STaVB／STV1〉1时，在诊断左主干病变的敏感性为82．1％，特异性83．8％，准确率83．3％。结论在运动试验中aVR和V1导联ST段抬高（STaVa／STV1〉1），对左主干病变有较高的预测价值。
英文摘要：
Objective To evaluate the value of lead aVR and V1 on the exercise electrocardiogram for the detection of left main coronary artery disease （ LMCAS ） in patients with the positive EET result （ Duke scores≤ - 11 ）. Methods Ninty-six patients with Duke score ≤ - 11 were retrospectively screened for pres- ence of ST-segment elevation in lead aVR and lead V1. Coronary arteriography （CAG） results were compared among different groups. Results Twenty-eight out of 96 were diagnosed as LMCAS. 24 out of 60 with ST-segment elevation in lead aVR and 26 out of 34 with ST-segment elevation in lead aVR and V1 （ STav/STv1 〉 1 ） were found to have LMCAS. Isolated exercise-induced ST elevation in lead aVR had a sensitivity of 85.5, a specificity of 47. 1% and an accuracy of 62. 5% in predicting LMCAS; ST-segment elevation in lead aVR and V1 （ STavR/STvl 〉 1 ） had a sensitivity of 82. 1% , a specificity of 83.8% and an accuracy of 83.3% in predicting LMCAS. Conclusion ST-segment elevation in lead aVR and V1 （ STavR/STV1〉 1 ） criteria has a high value in predicting LMCAS.
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