动态心电图诊断糖尿病伴冠心病的临床价值分析

目的 比较动态心电图在糖尿病及非糖尿病人群中诊断冠心病的临床意义。方法 将188名冠心病患者分为糖尿病组(n=65)及非糖尿病组(n=123)，根据冠状动脉造影及动态心电图结果分别计算两组动态心电图的诊断敏感性、特异性等参数，并用Logistic回归分析影响动态心电图结果的因素。结果：糖尿病组动态心电图诊断冠心病的敏感性高于非糖尿病组(P=0．046)。冠脉病变血管数、有无弥漫性病变及血管完全闭塞等因素与ST段阳性改变相关(OR=2．36，4．91，3．90)。结论 虽然动态心电图的敏感性、特异性有限，但是在糖尿病合并冠心病这样一个特殊人群，仍有一定的诊断价值。

Diagnostic Value of Holter Monitoring for Coronary Heart Disease in Diabetics

Objective To explore the diagnostic value of Holter monitoring for coronary heart disease (CHD) in diabetic and non-diabetic patients. Methods 188 patients with coronary heart disease were divided into diabetic group(n=65)and non-diabetic group(n=123). The diagnostic sensitivity, specificity, accuracy and other indices of Holter monitoring for CHD were compared between the two groups according to the results of angiography and Holter monitoring. Logistic regression analysis was applied to analyze the factors affecting holter ST-segment change. Results The sensitivity of Holter monitoring for diagnosing CHD in diabetic group was higher than that in non-diabetic group(P=0.046). There was an association between the positive ST-segment change and number of stenosal arteries, diffuse arterial lesion and complete vessel occlusion respectively (OR=2.36, 4.91, 3.90). Conclusion Although the sensitivity and specificity of Holter monitoring for diagnosing coronary heart disease were low, it remains some diagnostic value for coronary heart disease in diabetic patients.