影响疗养老干部ST-T改变正确诊断的原因探讨  

Probe into causes influencing exact diagnosis of ST-T changes for convalescent veteran cadres

作　　者：戴伟川[1] 冉启川[1] 李艳娟[1] 

机构地区：[1]广州军区桂林疗养院,541003

出　　处：《中国疗养医学》2013年第3期196-198,共3页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨影响军队疗养老干部ST-T改变正确诊断的主要原因。方法分析1490名来院疗养的男性老干部常规12导联心电图及临床体检资料。结果①ST-T改变检出率:共检出ST-T改变305例,检出率为20.5%(305/1490)。其中单纯ST段下移40例,T波低平121例,T波倒置8例,ST段下移伴T波低平124例,ST段下移伴T波倒置12例;②ST-T改变病因:病因明确者占43.3%(132/305),其中冠心病61例、高血压病43例、糖尿病19例、心肌病4例、低血钾3例、甲低2例,临床资料提供不全不能明确病因者占38.0%(116/305),罹患多种器质性疾病者占18.7%(57/305);③ST-T改变与年龄:<60岁组ST-T改变检出率为13.6%(50/369)、60～69岁组为18.5%(82/443)、70～79岁组为21.9%(113/517)、≥80岁组为37.3%(60/161)。结论临床体检资料不全以及ST-T改变形态特征不典型,是影响ST-T改变正确诊断的重要原因。Objective To probe into the major reasons that influence the exact diagnosis of ST-T changes for military convalescent veteran cadres.Methods Conventional 12-lead electrocardio-grams and clinical physical examination data of 1 490 hospitalized male vet-eran cadres at our sanatorium were analyzed. Results 1 .Detection rate of ST-T changes：305 cases had ST-T changes, accounting for 20.5%（305/1 490）.Among which 40 had mere ST segment depression, 121 had T-wave flatness,8 had T-wave inversion, 124 had ST segment depression and T-wave flatness,12 had ST segment depression and T-wave inversion.2.Causes of ST-T changes：43.3% （132/305） had clear causes, of which 61 had coronary heart disease, 43 had hypertension, 19 had diabetes, 4 had cardiomyopathy, 3 had hypokalemia, and 2 had hypothyroidism. 38.0% （ 116/305）had not clear causes because of incomplete clinical data. 18.7 % （57/305）had various organic diseases.3.ST-T changes and age：detection rate of ST-T changes was13.6% （50/369）under the age of 60,18.5% （82/443）between 60 and 69,21.9%（113/517）between 70 and 79,and 37.3%（60/161）over the age of 80.Conclusion Incomplete clini- cal data and atypical ST-T changes morphological characteristics are major causes influencing exact diagnosis of ST-T changes.

关 键 词：ST-T改变 心肌缺血 鉴别诊断 

分 类 号：R82[医药卫生—临床医学]