心电图与冠状动脉造影结果的对比分析  

Comparasion and analysis of the results between electrocardiography and coronary angiography

作　　者：刘芳[1] 陈元禄[2] 齐向前[2] 宋煜[1] 张健[1] 任自文[2] 陈庆华[1] 王建勇[1] 李玉亮[1] 

机构地区：[1]中国航空工业中心医院,100012 [2]泰达国际心血管病医院,300457

出　　处：《临床心电学杂志》2008年第1期16-19,共4页Journal of Clinical Electrocardiology

摘　　要：目的通过比较分析心电图改变与冠状动脉造影结果,探讨心电图在冠状动脉病变中的诊断作用。方法选择2003年11月至2005年11月住院患者中行冠脉动脉造影并符合非继发性ST-T改变的患者1178例,对心电图和冠脉动脉造影结果进行比较分析。结果①冠状动脉狭窄<70%组比狭窄50%～70%组、狭窄<70%组比无狭窄组更易发现ST-T异常(p<0.01),单支病变组与双支病变组、单支病变组与三支病变组比较有显著性差异(p<0.01)。②诊断性试验表明ST段比T波异常特异性高,T波比ST段异常敏感性高。③胸痛组敏感性稍优于非胸痛组(54.9%vs48.9%),特异性基本一致(67.9%vs67.3%)。结论心电图对冠心病诊断的敏感性偏低,但除外其它继发性ST-T改变的存在,心电图在一定程度上能准确反映冠状动脉病变情况。无ST-T改变情况下,有胸痛患者应进一步行心电连续监测和心电图负荷试验等确定诊断。Objective To discuss the value of electrocardiography in diagnosis of coronary artery diseases by comparing and analyzing the results between electrocardiography and coronary angiography, Methods 1178 patients excluding secondary ST-T changes who accepted CAG examinations were selected. The electrocardiographic changes were compared and analyzed with coronary angiography. Results （1）Abnormal ST-T changes were higher in the group with stenosis 〈70% than the group with stenosis 50%-70%. Like this, they were higher in the group with stenosis 〈70% than the group without stenosis（p〈0.01 ）. ST-T changes were different between singleand double-vessel disease, as the same as, between single- and three-vessel disease（p〈0.01 ）. （2）Diagnostic tests between ST-T changes and the diseased vessels showed that ST-T （＋）and ST （＋）were more sensitive for the group with stenosis 〈70% than 〈50%, specificitics were similar.3. Sensitivity （54.9% vs 48.9%）was greater for the group with chest pain than without chest pain, specificity was similar （67.9% vs 67.3%）. Conclusion Diagnostic test between ECG and CAG had poor sensitivity, but in some cases, the grade of diseased vessels could be reflected excluding secondary ST-T changes. Consecutive monitor and load test of ECG should be done for the patients with chest pain.

关 键 词：冠心病 心电图 冠状动脉造影 

分 类 号：R540.4[医药卫生—心血管疾病]