冠状动脉病变早期临床诊断的多因素分析  

The multiple factor analysis of clinical diagnosis in patients with early coronary heart disease

作　　者：李海斌[1] 陈士良[2] 李志樑[1] 

机构地区：[1]第一军医大学珠江医院心内科,广东广州510280 [2]解放军305医院心内科,北京100017

出　　处：《心脏杂志》2003年第4期333-335,共3页Chinese Heart Journal

摘　　要：目的 :评估各种方法对冠心病早期诊断的价值 ,探索早期冠心病的独立预报因子。方法 :收集 46例经冠状动脉造影确定的冠心病患者症状、静息心电图和常规临床检查等相关信息进行统计学分析。结果 :冠状动脉造影 2 1例正常 (正常组 ) ,2 5例出现冠状动脉狭窄 (冠心病组 ) ,平均狭窄程度为 (46± 15 ) %。比较两组的一般情况、临床症状、甘油三酯、胆固醇、低密度脂蛋白、负荷心电图、放射线及心脏超声等项目 ,各项指标无显著差异 ,L ogistic回归显示这些因素对冠心病的早期诊断无预测意义。结论 :冠心病患者的早期病变以临床常规各项方法难以准确检测和预报 ,冠状动脉造影是确诊冠心病者早期病变的最佳方法。AIM: To evaluate the utility of the common diagnostic examinations in patients with early coronary heart disease (CHD). METHODS: Forty-six patients with atypical clinical situation of CHD and normal resting electrocardiogram (ECG) experienced loading ECG,serum examination and X-radial telegraphy, and underwent coronary angiography(CAG). Then, identify the independent factor to CHD from these indexes by using Logistic regression. RESULTS: Patients were categorized into two groups based on the results of the arteriongraphy: control (21 cases) without artery stenosis and CHD (25 cases) with a mean artery stenosis of (46±15)%. Age, sex, blood pressure, clinical situation, serum triglycerides,serum cholesterol, serum low density lipoprotein, loading ECG, X-radial telegraphy, and ultrasonography of the heart were compared between the CHD and the control groups,and it was found that there was not any significant difference between the two groups. Logistic model showed that none of the above factors was an independent predictor to early CHD. CONCLUSION: The above routine non-invasive examinations help little in diagnosing early CHD, so it is suggested that CAG is a golden way early CHD can be diagnosed exactly.

关 键 词：冠状动脉疾病 冠状动脉造影术 心电描记术 

分 类 号：R540.4[医药卫生—心血管疾病]