动态心电图对老年冠心病患者在基层医疗中的作用  

The Diagnostic Value of 12-lead Ambulatory ECG in Elderly Patient with Coronary Artery Disease

作　　者：楚卡琳[1] 张萍[1] 李文斌[1] 

机构地区：[1]北京市积水潭医院老年科,100035

出　　处：《中国全科医学》2009年第18期1714-1715,共2页Chinese General Practice

摘　　要：目的评价12导联动态心电图在老年冠心病临床诊断中的价值,为基层社区医疗提供老年冠心病患者病情评估的依据。方法选择我院老年科门诊及社区门诊随诊的冠心病患者135例,动态心电图呈缺血型ST段压低,进行冠状动脉造影,将造影结果与动态心电图结果进行对比分析。结果经冠状动脉造影检查确定冠心病患者110例,诊断正确率为81.5%。动态心电图检出的ST段压低程度、持续时间与冠状动脉病变程度呈正相关,差异有统计学意义(P<0.05)。结论12导联动态心电图能够较准确地评价老年冠心病的病变程度,及时发现无症状心肌缺血,可作为是否需要进行冠状动脉造影和治疗的筛查依据,对有创检查有顾虑的老年冠心病患者尤为重要。Objective To evaluate the diagnostic value of ambulatory ECG in elderly patient with coronary disease. Methods Among geriatrics and community outpatients follow - up in our hospital, 135 cases coronary heart disease patients （ ≥ 60 year old ） with ischemic ST - segment depression showed in ambulatory ECG were selected for coranary angiography （CAG） . Then their results were comparative analyzed. Results Of 135 elderly patient with coronary artery disease 110 patients were confirmed by CAG. The sensitivity of ambulatory ECG proportion was 81.5% and extent of ST changed was relative with the length of ischemia and stenosis degree of coronary artery （ P 〈 0. 05 ） . Conclusion The 12 - lead ambulatory ECG can assess the severity of coronary heart disease relative accurately, detect silent myocardial ischemia timely. The coronary heart disease pa- tients whether or not to be proceeded further treatment and coronary angiography （CAG） can be screening based on it. That is particularly important for elderly patients who have poor tolerance for invasive examination.

关 键 词：冠状动脉疾病 心电描记术 冠状动脉造影 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]