拟诊冠心病患者心电图与冠状动脉造影结果分析

 目的通过对178例拟诊冠心病患者的静息心电图(ECG)与冠状动脉造影结果进行回顾性分析,评价静息心电图(ECG)对冠心病诊断和预后的价值.方法选择有冠心病典型症状及危险因素的患者,男109例、女69例,年龄62.5(61.5±11.1)岁.其中,99例患者ECG有心肌缺血表现(ECG阳性组),79例无心肌缺血表现(ECG阴性组).对所有拟诊患者进行冠状动脉造影(CAG)检查.结果静息ECG阳性与阴性组患者,CAG阳性率无显著性差异(54.5%vs 59.5%,P＞0.05);静息ECG对冠心病诊断的敏感性为56.4%,特异性为36.8%;静息ECG阳性组多支病变率明显高于ECG阴性组(66.7%vs 44.7%,P=0.029);静息ECG阴性组单支病变率明显高于ECG阳性组(55.3%vs 33.3%,P=0.026).静息ECG阳性组高血压患病率明显高于ECG阴性组(P=0.042).结论静息ECG阳性对诊断冠心病的特异性和敏感性低,对多支、多危险因素的高危冠心病患者具有一定的提示意义.

Diagnostic and prognostic value of electrocardiography and coronary angiography in patients with suspected coronary heart disease

Objective To evaluate the diagnostic and prognostic value of resting electrocardiography (ECG)and coronary arteziography(CAG) in patients with suspected coronary heart disease (CHD).Methods 178 patients (109 males,69 females, average age 62.5 years) with confirmed risk factors and typical symptoms of CHD were studied.All the patients underwent resting ECG and subsequent CAG.ECGs of ischemic pattern in 99 patients (ECG positive group ) and were normal in the other 79 (ECG negative group).Results There was no significant difference in the positive rate of CAG between ECG positive and ECG negative groups (54.5% vs 59.5%, P>0.05).The overall sensitivity and specificity of ECG in detecting CAD were 56.4% and 36.8%,respectively.ECG positive group had a higher rate of multi-branch coronary artery stenosis than did ECG negative group (66.7% vs 44.7%,P=0.029), and a lower rate of single coronary artery stenosis than did ECG negative group (33.3.3% vs 55.3%,P=0.026). But the number of patients with hypertension in ECG positive group was higher than that in ECG negative group (P=0.42).Conclusion The resting ECG does not have high sensitivity and specificity in detecting CAD, but it seems to be valuable in diagnosting CAD with multiple risk factors or multi-branch coronary artery stenosis.