冠心病的临床诊断和几种检查手段诊断效果的对比分析

目的 比较冠心病的临床诊断和几种检测手段诊断的诊断价值。方法 搜集国内近10年来发表的临床诊断或拟诊冠心病。且行冠状动脉造影和心电图和／或动态心电图、核素心肌灌注断层显像、超声心动图的病例，对其归纳分析。结果 在临床诊断或拟诊冠心病19180例病例中，有66．6％冠状动脉造影阳性；以冠状动脉造影的结果作为对照，核素心肌显像的诊断灵敏度为88．7％，静息超声心动图为65．7％，负荷超声心动图为74．2％，负荷心电图69．2％，运动心电图74．3％，动态心电图为63．0％。结论 建议对有胸痛、胸闷主诉且静息心电图有ST—T阳性改变的患者，临床进行冠心病诊断时应当谨慎，选择适当的辅助检查可提高诊断准确性。

Comparison of diagnostic effects of some examining methods to detect the coronary artery disease

Objective To investigate the effect of clinical and other examining methods for detecting coronary artery disease. Methods The cases of coronary artery disease published in Chinese medical periodicals were summarized. All the patients diagnosed by clinical characters and/or electrocardiography underwent coronary angiography and one or more examinations including echocardiography, electrocardiogram and radionuclide imaging. Results Among 19 180 patients diagnosed clinically, 66.6% were proved by coronary angiography. Compared with coronary angiography, the diagnosis rate of radionuclide imaging was 88.7%, echocardiography was 65.7%, echocardiography stress test 74.2%, stress electrocardiogram 69.2%, exercise electrocardiogram 74.3%, and dynamic electrocardiogram 63%. Conclusion A physician must be careful to diagnose the coronary artery disease for patients with depressed and painful chest, with positive changes of ST-T. With the help of other examining methods, the diagnostic accuracy may be improved.