目的　研究aVR导联对急性冠脉综合征是否有预测意义。方法　分析了 1998～ 2 0 0 3年间在青岛大学医学院附属医院因首次非ST段抬高急性冠脉综合征入院的 5 71例病人的aVR导联抬高情况。将这些病人按aVR导联有无ST段抬高分为aVR导联无ST段抬高 ,ST段抬高 0 0 5～ 0 10mV及 >0 10mV三组。结果　在aVR导联无ST段抬高、ST段抬高 0 0 5～ 0 1mV及 >0 10mV 3组的病人中其病死率分别为 2 0 %、11 0 %及2 2 0 %。三支及主干病变分别为 2 5 0 %、4 4 1%及 6 0 0 %。三者间的CK -MB变化差异无显著性。结论　aVR导联ST段抬高的急性冠脉综合征 ,血管病变往往较重 ,预后亦较差 ,尽早冠脉介入治疗是有必要的。 Objective To investigate whether aVR lead has predictive value for acute coronary syndrome. Methods The aVR elevation in 571 patients hospitalized for the first time in non-ST-segment elevation acute coronary syndromes at Affiliated Hospital of Qingdao University from 1998 to 2003 was analyzed. According to aVR lead without ST-segment elevation, these patients were divided into aVR lead without ST segment elevation, ST segment elevation 0 0 5 ~ 0 10mV and> 0 10mV three groups. Results In the aVR lead group, there was no ST-segment elevation, and the case-fatality rates in ST segment elevation 0 0 5 ~ 0 1mV and> 0 10mV 3 groups were 20%, 110% and 220% respectively. Three branches and trunk lesions were 250%, 441% and 600% respectively. CK-MB among the three differences was not significant. Conclusions The aVR lead ST segment elevation acute coronary syndrome, vascular lesions tend to be heavier, the prognosis is also poor, as soon as possible coronary intervention is necessary.