心电图ST-T段动态变化诊断冠心病的价值分析

目的：分析研究心电图ST-T段动态变化对诊断冠心病的临床价值，对临床诊断提供更准确的诊断方法。方法抽取2013年4月～2016年4月间收治的疑似冠心病患者1200例作为研究对象，所有患者均经详细的病史采集、查体及其他相关辅助检查后，实施心电图冠状动脉CTA或冠状动脉造影检查，按照心电图ST-T段动态变化的结果将其分为A组（ST-T段动态变化）和B组（ST-T段无动态变化），并以冠状动脉CTA及冠状动脉造影检查结果为依据，对两组患者的确诊率进行比较。同时，按照冠心病患者的患病血管支数不同将其分为单支病变组和多支病变组，对两亚组患者心电图ST-T段动态变化检出结果进行比较，分析病变血管支数与心电图ST-T段动态变化之间的相互关系。分别计算心电图ST-T段动态变化诊断冠心病的灵敏度、特异性、准确度。结果本文1200例疑似冠心病患者经冠状动脉造影检查，确诊为冠心病的有534例，诊断阳性率为44.50%。将A、B两组患者的心电图诊断结果与冠状动脉造影检测结果进行对照，可见其各自的确诊率分别为66.03%和34.98%，伴ST-T段动态改变的患者的确诊率显著更高，比较差异有统计学意义（P＜0.05）。将已经确诊为冠心病的534例患者分为单支病变组和多支病变组，分别比较其心电图ST-T段动态变化检出阳性率，结果为69.20%和68.71%，比较差异无统计学意义。心电图ST-T段动态变化诊断冠心病的灵敏度、特异性、准确度，结果分别为66.03%、65.02%、65.33%。结论通过心电图ST-T段动态变化可以对冠心病的发生进行诊断，有一定的临床应用价值。

Value analysis of dynamic changes of electrocardiogram ST-T segment in diagnosis of coronary heart disease

Objective To analyze the clinical value of ST-T segment of electrocardiogram in diagnosis of coronary heart dis-ease, and to provide more accurate diagnostic methods for clinical diagnosis. Methods Selected in April 2013 to 2016 were treated between April suspected 1 200 cases of patients with coronary heart disease (CHD) as the object of study, all patients were the de-tailed history collection, check body and other related auxiliary examination, the implementation of electrocardiogram coronary angi-ography or coronary angiography. According to the results of ECG ST-T segment changes will be the group A (ST-T changes) and group B (without ST-T segment changes), and coronary artery CTA and coronary artery angiography result as the basis, of two groups of patients diagnosed rate were compared. At the same time, the coronary heart disease patients with diseased vessels of the single branch lesions group and multi branch lesion group in accordance with the, of two subgroups of patients electrocardiogram ST-T change detection results are compared. The relationship between the number of diseased vessels and ST-T segment changes was analyzed. Calculated ECG ST-T segment dynamic changes in the diagnosis of coronary artery disease sensitivity, specificity, ac-curacy. Results 1 200 cases of suspected coronary heart disease patients with coronary angiography, diagnosis of coronary heart dis-ease in 534 cases, the positive rate was 44.50%. The A, B two groups of patients ECG diagnosis and coronary artery angiography were performed to detect the results were compared, visible their diagnosis rate was 66.03%and 34.98%respectively, with ST-T seg-ment dynamic change in patients with diagnosed rate was significantly higher, compared with statistical difference (P<0.05). Will have been diagnosed 534 cases of coronary heart disease patients divided into single branch lesions group and multi branch lesion group, respectively, in comparison with the ST-T segment changes detection positive rate, the result is 69.20%and 68.71%, there was little difference, no statistical significance. The sensitivity, specificity and accuracy of ST-T segment changes in ECG were 66.03%, 65.02%and 65.33%, respectively. Conclusion The ST-T segment of ECG can be used to diagnose coronary heart disease, and it has a certain value in clinical application.