心电图ST段水平延长对冠心病的诊断分析  

Diagnosis of coronary heart disease with prolongation of ST segment in electrocardiogram

作　　者：潘玥 Pan Yue(The First Affiliated Hospital of Jinzhou Medical University,Liaoning Jinzhou 121000)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《中国社区医师》2021年第5期116-117,共2页Chinese Community Doctors

摘　　要：目的:分析心电图ST段水平延长在冠心病诊断中的应用价值。方法:选取冠心病患者71例,归入研究组;将有心绞痛史但冠脉造影检查正常的患者77例,归入对比组。对所有患者实施常规12导联检查,分析检查结果。结果:对比组ST段水平延长及T波改变检出率均明显低于研究组,差异有统计学意义(P<0.05)。ST段水平延长冠心病诊断准确度为80.41%、敏感度为87.32%、特异度为74.03%,阳性预测值为75.61%,阴性预测值为86.36%。T波改变冠心病诊断准确度为83.11%、敏感度为95.77%、特异度为71.43%,阳性预测值为75.56%,阴性预测值为94.83%。两种诊断方式诊断准确度、特异度及阴性预测值比较,差异无统计学意义(P>0.05);T波改变诊断敏感度及阳性预测值高于ST段水平延长,差异有统计学意义(P<0.05)。研究组ST段及J-Tc段均长于对比组,冠心病多支病变组ST段及J-Tc段均长于单支病变组,差异均有统计学意义(P<0.05)。结论:心电图ST段水平延长在冠心病诊断中的应用价值较高,联合应用T波改变进行诊断,可防止出现漏诊或误诊等现象。Objective:To analyze the application value of electrocardiogram ST segment prolongation in the diagnosis of coronary heart disease.Methods:71 patients with coronary heart disease were enrolled in the study group.77 patients with angina pectoris history but normal coronary angiography were included in the control group.All patients were given routine 12 lead examination and the results were analyzed.Results:In the control group,the detection rates of ST segment extension and T wave change were significantly lower than those in the study group,the difference was statistically significant(P<0.05).The diagnostic accuracy of ST segment prolongation in the diagnosis of coronary heart disease was 80.41%,the sensitivity was 87.32%,the specificity was 74.03%,the positive predictive value was 75.61%,and the negative predictive value was 86.36%.The accuracy of T wave change in the diagnosis of coronary heart disease was 83.11%,the sensitivity was 95.77%,the specificity was 71.43%,the positive predictive value was 75.56%,and the negative predictive value was 94.83%.There was no significant difference in diagnostic accuracy,specificity and negative predictive value between the two diagnostic methods(P>0.05).The diagnostic sensitivity and positive predictive value of T wave were higher than that of ST segment prolongation,the difference was statistically significant(P<0.05).In the study group,ST segment and J-Tc segment were longer than those in the control group,in the multi vessel coronary artery disease group,ST and J-Tc segments were longer than those in the single vessel disease group,the difference was statistically significant(P<0.05).Conclusion:The application value of electrocardiogram ST segment prolongation in the diagnosis of coronary heart disease is higher,combined application of T wave changes can prevent missed diagnosis or misdiagnosis.

关 键 词：心电图 ST段水平延长 T波改变 冠心病 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]