U波异常对缺血性心脏病的诊断价值探讨  

Abnormal U waves in the diagnosis of the ischemic myocardial disease

作　　者：郑志雄[1] 马国庆[1] 郑志萍[2] 钱学贤[3] 

机构地区：[1]空军杭州疗养院,310013 [2]福建医科大学附属一院,350004 [3]第一军医大学珠江医院,510282

出　　处：《中国疗养医学》2003年第3期202-205,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的　探讨 U波异常在诊断缺血性心脏病中的价值。方法　选择临床疑为冠心病的男性患者 5 2例 ,应用常规心电图、运动负荷心电图及冠脉造影 ,分析 S段缺血性改变、U波异常在诊断缺血性心脏病中的敏感性和特异性。结果　冠脉造影阳性 38例中 ,常规心电图 ST段呈缺血性改变者 16例 ,U波异常者 8例 ,其诊断缺血性心脏病的灵敏度分别为 4 2 .11%、2 1.11% (16 / 38、8/ 38) ;运动试验阳性者 2 6例 ,运动诱发 U波异常者 15例 ,其诊断缺血性心脏病的灵敏度分别为 6 8.4 2 %、39.4 7% (2 6 / 38、15 / 38)。冠脉造影阴性者 (n=14 )中 ,常规心电图 ST段无缺血性改变 6例 ,U波正常 13例 ,特异度分别为 4 2 .86 %、92 .86 % (6 / 14、13/ 14 ) ;运动负荷时 ,结果阴性 9例 ,U波正常 14例 ,特异度分别为 6 4 .2 9%、10 0 % (9/ 14、14 / 14 )。结论　 U波异常在诊断缺血性心脏病中敏感性虽不如 ST段下移的高 ,但 U波异常的特异性高 ,尤其是运动诱发的 U波异常更具诊断价值 ;缺血性 U波异常有助诊断冠心病。Objective In order to study the diagnostic significance of abnormal U waves in the ischemic heart disease.Methods 52 male patients with suspended coronary heart disease were subjected to routine electrocardiography,treadmill test and coronary arteriography.And their ECG ischemic ST segment,abnormal U waves were compared to the findings of the coronary arteriography to evaluate the sensitivity and the specificity.Results Among 38 patients with pathological coronary stenosis in coronary arteriography,ischemic ST segments were found in 16 subjects,and abnormal U waves were 8 in routine ECG. Their sensitivity for diagnosing the ischemic heart disease were 42.11%?21.11%(16/38?8/38),respectively.There were 26 patients with positive results and 15 with abnormal U waves during treadmill testing.Their sensitivity for diagnosing the ischemic heart disease were 68.42%?39.47?(26/38?15/38),respectively.of 14 subjects with normal coronary findings in coronary arteriography,there were 6 cases with normal ST segments and 13 with normal U waves in routine ECG test.Their specificity for the diagnosing of the ischemic heart disease were 42.86%?92.86%(6/14?13/14),respectively.There were 9 with negative results,and 14 with normal U waves during treadmill testing.Their specificity were 64.29%?100%(9/14?14/14),respectively.There were 2 other cases with exercise-induced U waves as the only abnormal finding,who had pathological coronary stenosis in coronary arteriography.Conclusion Abnormal U waves is of high specificity for the diagnosis of ischemic heart disease,though its sensitivity is not so high as that of the depress of ST segment.Exercise-induced U waves is especially useful in the diagnosis.The U wave crieteria are helpful in the diagnosis of the coronary heart disease.

关 键 词：U波异常 缺血性心脏病 诊断价值 临床诊断学 心电图 统计方法 灵敏度 

分 类 号：R540.41[医药卫生—心血管疾病]