心电图ST-T改变对冠心病的诊断价值  

Diagnostic value of ECG ST-T changes for coronary heart disease

作　　者：苏冠丽[1] 韩彩莉 籍文强[1] 刘刚[2] 

机构地区：[1]河北医科大学第一医院急诊科,河北石家庄050031 [2]河北医科大学第一医院心脏中心,河北石家庄050031

出　　处：《实用心电学杂志》2016年第4期233-239,共7页Journal of Practical Electrocardiology

基　　金：河北省医学科学科研课题资助项目(ZL20140141);河北省科技计划项目(16277707D;13277720D)

摘　　要：目的研究ST-T改变是否能提供超越其他测量指标的对冠心病的诊断价值。方法本研究选择在我院心血管内科住院,并行冠状动脉造影的患者共385名。根据明尼苏达编码,统计入选患者心电图ST-T改变情况,分析冠状动脉造影与心电图改变的关系,并对造影阳性患者进行病变程度分类统计,评估心电图ST-T改变与冠心病严重程度的关系。结果在所有受试的385名患者中,冠脉造影阳性患者297例,心电图有阳性改变的为177例;冠脉造影阴性患者88例,心电图有阳性改变的为30例,差异有统计学意义(P<0.001)。在冠脉造影阳性的患者中,单支病变患者有97例,其中心电图阳性48例,阴性49例;多支病变患者有200例,心电图阳性129例,阴性71例,差异有统计学意义(P<0.05)。结论基于明尼苏达编码的心电图ST-T改变标准判读心电图,ST-T改变对患者冠心病有诊断价值,在已明确诊断为冠心病的患者中,ST-T改变对冠状动脉存在多支病变有诊断价值。Objective To judge whether the diagnostic value of ST-T changes for coronary heart disease（ CHD） is higher than other indices. Methods A total of 385 patients were enrolled in our study,who had been admitted in the department of Cardiology in our hospital and underwent coronary arteringraphy（ CAG）. The ST-T changes of their ECGs were recorded statistically by Minnesota code,and the relationship between CAG results and ECG changes was analyzed. In addition,the patients with positive CAG results were classified according to the severity of CHD,and the relationship between ST-T changes of ECG and the severity of CHD was evaluated. Results In all the 385 cases who had undergone CAG examination,there were 297 cases with positive results in whom 177 were observed positive ECG changes; there were 88 cases with negative results in whom 30 were observed positive ECG changes,and the difference was statistically significant（ P〈0. 000 1）. Among the patients with positive CAG results,97 cases were diagnosed with single vessel disease including48 case with positive ECG results and 49 with negative ECG results; Two hundred cases were diagnosed with multi-vessel coronary artery disease including 129 case with positive ECG results and 71 with negative ECG results,and the difference was statistically significant（ P〈0. 05）. Conclusion If we analyze ECG with the standard of ST-T changes by Minnesota code,ST-T changes will befound clinically valuable in diagnosing CHD. Among the patients who were diagnosed with CHD,ST-T changes prove to have diagnostic value for the ones with multi-vessel coronary artery disease.

关 键 词：ST-T改变 冠心病 冠脉造影 明尼苏达编码 

分 类 号：R540.41[医药卫生—心血管疾病]