安静心电图诊断慢性冠状动脉供血不全敏感性特异性准确性的探讨  

The sensitivity specificity and accuracy of rest electrocardiogram for diagnosis of coronary heart disease

作　　者：钱卫民[1] 王海裕 伍彩英[1] 袁咏喈[1] 冯建章[1] 

机构地区：[1]广东省心血管病研究所,广州市510080 [2]台山市人民医院心内科

出　　处：《岭南心血管病杂志》1998年第4期234-236,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的评价安静心电图诊断冠心病的价值。材料和方法采用冠脉造影和安静心电图相对照的方法，评价安静心电图诊断冠心病的特异性敏感性准确性。142人因胸闷胸痛疑心绞痛病人人院行冠状动脉造影，按冠脉造影结果分为二组；冠状动脉粥样硬化组（冠心病组）和冠状动脉造影正常组（非冠心病组）。冠心病组91例，男性75例，女性16例。平均年龄（56．08±8．18）岁。非冠心病组51例，男性26人，女性25人。平均年龄（52．15±7．96）岁。心电图机为麦克心电图机，按其心电图表现分为心肌缺血，心肌劳损，心肌梗死、心律失常和正常心电图五类。仪器和冠脉造影方法；冠状动脉造影用RPhilip心血管造影X光机。造影方法采用Judkins法。结果冠状动脉狭窄的91人中，心电图有缺血性心电图表现者14人，占15．4％。心肌梗死心电图表现者24例，占26．4％。心肌劳损者31例，占34．1％。心律失常者27例，占29．7％。正常心电图14人，占15．4％，在51例冠脉造影正常人中，有心肌缺血者心电图表现者3人，约占6％。有典型陈旧性心肌梗死心电图表现者3人，约占6％。心肌劳损心电图表现者17人，占33．3％。心律失常者9人，占17．6％。正常心电图者20人，39．2％。讨论和结论普通心电图诊断陈旧性心肌梗死的价值最高，其敏感性100％?Objectives We sought to investigate foe specificity sensihvity and acey ofrest ECG for diagnosis Of chIDnic coromp heall disease. Me The coroner healt disease werediagnosed by coromp angiogrphe ,andisea 142 pem tmderwent aams Paredme. Accowhng to the coronaly arteriography, They were divided into tWo , coronap heal't disease and non coron heall disc.All of them take adoly of rest ECG. Resultsis giPatients ~fest athe^lerosis which are confirmedby coroner arterio~. There are patare 14 Patients(15 .4% ) whine ECG shoWS ischenda abnormanitisties,24 pahents ECG appears old myocardialal infactiohon(ic. 4% ). 31 persons ECG expresses mrocedaldamage and 27 have caldiac arrhytmials (29.7% ),there are 14 pehents with noed ECG (15.4%).sl perms in coned gIDup have nounal coronmp arteriography. 3 Of them express cedac iSChenda(6% ). 3 aPPear old myocndial infaretion (6% ).17 Patients ECG express myocedal infalty damage(33.3%) 9 Pahents have arrhythmia a (17. 6%),there ~ 20 Patients with noed ECG (39. 2% ).Dission and Consclusisn~ our study find thatmany abnoedihes of ECG mp be found in patients with chIDnic isohendc hod disease but somepatients ECG may be nounal even if they are ill wilh severecoronary obstruction. Among teh abnormalities, the abnormal Q waves and QS complexes are extremelely valuable in diagnosis of coronap heart disease, they are reliable and repopucible. The manifestations of abnomal Q waves and QS complexes areheig of highersensihvity which is abet 100%, specificity is of 96%. ST segment depression and deeply and sylnmetrically inversion of T wave shOW low sensitivity and high specificity for diagnosis of ischeda. It is only 15% sensitivity for ischenda, but it is of 96% specificity. ECG can be taken as basic methed for diagnosis of coronary heart disease.[

关 键 词：心电图 缺血性心脏病 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]