12导联动态心电图诊断冠心病下壁心肌缺血的意义

目的　探讨 12导联动态心电图 (Holter)对冠心病患者下壁心肌缺血的诊断价值。方法　对比分析 96例临床疑诊冠心病 (CHD)患者的 12导联Holter监测与冠状动脉造影 (CAG)结果。结果　12导联Holter诊断冠心病下壁心肌缺血的敏感性为 6 4 91% ,特异性为 5 3 85 % ,阳性预测价值6 7 2 0 %。Holter检查下壁心肌缺血的阳性检出率在单纯右冠状动脉病变 (单支病变组 )、右冠状动脉合并左前降支或回旋支病变 (双支病变 )组、三支病变组分别为 2 0 %、70 37%和 80 %。结论　 12导联Holter对冠心病下壁心肌缺血具有一定的定位诊断价值 ,但应密切结合临床。

Value of 12-lead Holter monitoring for diagnosis of inferior myocardial ischemia with coronary heart disease

Objective To evaluate the clinical value of 12-lead Holter monitoring for coronary heart disease (CHD) patients with inferior myocardial ischemia. Methods Ninety-six patients with CHD had accepted coronary angiography (CAG) and 12-lead Holter examination. Results The sensitivity for detecting inferior myocardial ischemia in 12-lead Holter monitoring was 64.91%, the specificity 53.85%, and the positive detecting value 67.20%. In 12-lead Holter monitoring, inferior myocardial ischemia was recorded in 20% of only RCA lesion group, and in 70.37% of double -vessel lesion group, and in 80% of three-vessel lesion group.Conclusion 12-lead Holter monitoring is of some value to evaluate the inferior myocardial ischemia in CHD patients, but other clinical data should be considered.