老年患者常规静息心电图ST-T改变与冠状动脉病变的临床探讨  

Clinical study of the relationship between the ST-T change of elder patients' conventional resting electrocardiogram and coronary heart disease

作　　者：崔勇[1] 徐韬[1] 赵东华[1] 孙熙璇[1] 宿志庆[1] 李志平[1] 

机构地区：[1]山东省聊城市人民医院,252000

出　　处：《实用心电学杂志》2011年第1期36-38,共3页Journal of Practical Electrocardiology

摘　　要：目的探讨老年患者静息心电图ST-T变化对冠心病的诊断价值。方法对193例接受冠状动脉造影的非心肌梗死老年患者的心电图资料进行分析,与冠脉造影和超声心动图结果相比较。结果经冠脉造影证实160例冠心病患者中心电图ST-T改变的阳性率仅59.37%,单支冠脉狭窄心电图阳性率56.66%,双支冠脉狭窄阳性率为60.41%,而多支冠脉狭窄阳性率为61.53%,心电图ST-T改变与冠状动脉的狭窄支数的相关性不呈正相关。心电图呈慢性ST-T改变的病人中近70%超声心动图示左室肥大、左房扩大或瓣膜钙化,去除心脏结构改变这一主要影响因素后,冠心病患者常规静息心电图ST-T改变的阳性率仅有不到19%,提示心电图慢性ST-T改变并非冠心病心肌缺血所致,而与左心室、左心房肥厚或扩张及瓣膜的病变具有重要的关系。结论常规静息心电图慢性ST-T改变不能做为冠心病的诊断依据。Objective Explore the value of the ST - T change of elder patients＇resting electrocardiogram in the diagnosis of coronary artery disease. Methods The electrocardiograms of the 193 non - myocardial infarction elder patients are analyzed and then compared with the results of their own coronary angiography and echocardiography. Results It is proved through the coronary angiography that among the 160 patients with coronary heart disease, the positive rate of ST - T change in electrocardiogram is only 59.37%, single coronary stenosis in electrocardiogram is 56.66%, double coronary stenosis is 60.41%, multi coronary stenosis is merely 61.53%. So, the ST - T change and the number of coronary stenosis do not positively correlate. Left ventricular hypertrophy, left atrium expansion and valve calcification were found in the ech- ocardiography of nearly 90% of these patients with chronic ST - T change in their electrocardiogram. Without the major influential factor of the structural change of heart, the positive rate of ST - T change of the conventional resting electrocardio- gram of patients with coronary heart disease is only less than 19%, which shows that the chronic ST - T change of electro- cardiogram does not result from the myocardial isehemia of coronary heart disease, but from the fatness or the expansion of the left ventricular and left atrium, as well as the pathological changes of the valves. Conclusion The chronic ST - T change of conventional resting electrocardiogram could not serve as the diagnostic basis of coronary artery disease.

关 键 词：冠心病 心电图 冠状动脉造影 

分 类 号：R540.41[医药卫生—心血管疾病]