冠脉造影与12导联常规心电图对冠心病诊断的对比分析  

Contrast Analysis on Coronary Angiography and 12 Leads of ECG in Diagnosis of Coronary Heart Disease

作　　者：黎桃园[1] 葛郁芝[1] 刘艳阳[1] 盛国太[1] 余茂生[1] 吴志勇[1] 周裔忠[1] 

机构地区：[1]江西省人民医院心内科,江西省心血管病研究所,江西南昌330006

出　　处：《现代诊断与治疗》2008年第6期326-329,共4页Modern Diagnosis and Treatment

摘　　要：目的通过心电图(ECG)改变与冠脉造影(CAG)的对比分析,探讨常规12导联ECG对冠状动脉病变的诊断价值。方法分析2007年7月～2008年6月拟诊冠心病(CHD)并行CAG患者(105例)的造影及冠脉造影前ECG资料。以左主干、前降支、回旋支、右冠状动脉中任一支狭窄≥50%者为阳性,按CAG结果将其分成阳性组与阴性组,阳性组依狭窄的程度或支数分组,对各组的灵敏度(阳性率)、特异度(阴性率)、假阳性率、假阴性率等指标进行统计学分析。结果ECG诊断CHD的灵敏度68.6%、特异度57.1%、假阳性率42.9%、假阴性率31.4%、阳性试验预测值76.2%、阴性试验预测值47.6%、CAG阳性组与阴性组ECG结果比较,具有显著统计学差异(P<0.01);狭窄50%～70%(A)组、70%～90%(B)组、≥90%(C)组,ECG灵敏度分别为47.1%、60%、75.6%,假阴性率分别为52.9%、40%、24.4%。比较三组ECG结果的差异性,结果A组与B组比较,无显著统计学差异(P>0.05),A组与C组比较,具有显著统计学差异(P<0.01),B组与C组比较,无显著统计学差异(P>0.05);狭窄一支组、狭窄二支组、狭窄三支组,ECG灵敏度分别为62.5%、70.8%、72.7%,假阴性率分别为37.5%、29.2%、27.3%,三组ECG结果无显著统计学差异(P>0.05)。结论ECG对CHD具有一定的诊断价值;ECG灵敏度与CHD患者冠脉狭窄程度的相关性较大,随着狭窄程度加重,ECG灵敏度增高明显,有显著统计学差异;ECG灵敏度与CHD患者冠脉狭窄支数的相关性较小,随狭窄支数增加,ECG灵敏度增高,但无显著统计学差异。Objective To discuss the value of routine 12 leads of ECG in the diagnosis of coronary heart disease（CHD） by comparing and analyzing the relationship between the change of surface electrocardiogram （ECG） and coronary, angiography（CAG）. Method The ECG and CAG films of 105 suspected CHD patients during July,2007 to June ,2008 were analyzed. The stenosis≥50% in any one branch of left main（LM） ,anterior descending artery （ LAD）, left circumflex artery （LCX） or right coronary artery （RCA） was positive. The patients were divided into positive and negative groups according to CAG results. Positive cases were classified by stenotic levels or stenosis branches. The sensitivity of each group（ positive rate）, specificity（ negative rate）, false positive rate, false negative rate, and other indicators were statistically analysed. Results The sensitivity of ECG diagnosing CHD was 68.6% ,the specificity was 57.1% ,the false positive rate was 42.9% and false negative rate was 31.4% ,the predictive rate of positive test was 76.2%, predictive rate of negative test was 47.6%. Comparing and analyzing the results of CAG positive group and CAG negative group, there were a significant differences（ P 〈 0.01 ）. In the group of 50% - 70% stenosis（ group A） ,group of 70% - 90% stenosis （ group B）, group of - 90 % stenosis （ group C ）, the sensitivity of ECG was 47.1%, 60% ,75.6%, respectively ;the false negative rate was 52.9% ,40% ,24.4% ,respectively. Comparing the ECG results of three groups, the differences were not significant between group A and group B or group B and group C （ both P 〉 0.05 ）, while the difference between group A and group C was statistically significant（ P 〈 0.01 ）. The sensitivity of ECG in one stenotic branch group, two stenotic branches group, three stenotic branches group was 62.5% ,70. 8% ,72.7% ,respectively. The false negative rate was 37.5% ,29.2% and 27.3% ,respectively. Comparing there groups of ECG results, three were no significant diff

关 键 词：冠心病 心电图 冠脉造影 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]