以冠状动脉造影结果重新评价心电图对冠心病的诊断价值

目的]了解拟诊为冠心病患者的心电图(ECG)改变在诊断冠心病方面的价值。方法]对375例拟诊为冠心病的患者的心电图和冠状动脉造影(CAG)的结果进行分析。结果]375例中252例ECG异常,123例正常;经冠状动脉造影检查,278例确诊为冠心病,97例除外冠心病;心电图异常的252例有205例诊断为冠心病,心电图正常的123例有73例诊断为冠心病,ECG诊断冠心病的敏感度(sensitivity)为73.7%,特异度(specificity)为51.5%;心电图的不同改变对于冠心病的诊断意义不同(P<0.001)。异常Q波的96.8%、ST段抬高的90.0%、ST段下移的83.7%诊断为冠心病。结论]拟诊为冠心病患者进行普通体表心电图检查的价值有限,其不同导联所致的不同改变对诊断冠心病的意义不同。

Re-evaluation of Diagnostic Value of Electrocardiography for Coronary Heart Disease by Coronary Arteriography

Objective] To re-evaluate the diagnostic value of electrocardiogram (ECG) for coronary heart disease (CHD) by coronary arteriogram (CAG). Methods] ECG and CAG in 375 cases preliminarily diagnosed as having CHD were analyzed. Results] ECG was abnormal in 252 cases and normal in 123 cases; 278 cases were diagnosed as having CHD and 97 non-CHD by CAG. CHD was confirmed in 205 cases from 252 with abnormal ECG and in 73 cases from 123 with normal ECG. The sensitivity of ECG for CHD was 73.7% and the specificity was 51.5% , indicating that the changes of ECG having different diagnostic value for CHD (P < 0.001). In abnormal ECG, changes such as abnormal Q wave, ST-segment elevation and ST-segment depression were valuable for the diagnosis of CHD, their diagnostic rate being 96.8%, 90.0% and 83.7% respectively. Conclusion] Body surface ECG has limited value for confirmed diagnosis of CHD; the diagnostic value of ECG varies with the different leads.