心电图 ST-T 缺血性改变与冠状动脉病变的关系

目的：从诊断学的角度分析心电图ST-T缺血性改变与冠状动脉病变的关系。方法：收集2013年6月至2014 年4月在中南大学湘雅三医院心血管内科行冠状动脉造影检查的341例心血管疾病患者的一般资料和心电图检查结果 等，ST-T缺血性改变的判断采用国际常规心电图ST-T缺血性改变的诊断标准；冠状动脉造影采用国际Judkins法冠状 动脉造影诊断标准，分析心电图检查的灵敏度和特异度。结果：心电图ST-T缺血改变女性多于男性(P<0.01)；不同性 别的冠状动脉造影缺血改变差异无统计学意义(P>0.05)；心电图ST-T缺血性诊断冠心病的灵敏度为83.6%，特异度为 54.4%；诊断男性的灵敏度为82.3%，特异度为68.0%；诊断女性的灵敏度为85.0%，特异度为28.2%。结论：心电图ST-T 缺血改变对冠心病的诊断有重要价值，心电图诊断心肌缺血的特异度男性高于女性，灵敏度女性高于男性。

Relationship between the ischemic ST-T changes in ECG and the coronary artery diseases

Objective: To analyze the relationship between the ischemic ST-T changes in electrocardiogram (ECG) and the coronary artery diseases based on the perspective of diagnostics. Methods: A total of 341 patients, who underwent coronary angiography in Department of Cardiology of Xiangya Hospital, Central South University from June 2013 to April 2014, were enrolled for this study. Th e internationally recognized diagnostic criteria for ischemic ST-T changes in ECG and the Judkins diagnostic criteria for coronary angiography were applied, respectively. Th e sensitivity and specifi city of ECG were analyzed. Results: Th ere were more ischemic ST-T changes in women than that in men (P<0.01). Ischemic changes in coronary angiography were not signifi cantly diff erent between male and female patients (P>0.05). For ischemic diagnostic tests by ECG ST-T, the total sensitivity and specificity was 83.6% and 54.4%, respectively. The sensitivity and specificity was 82.3% and 68.0% or 85.0% and 28.2% in the male or female group, respectively. Conclusion: Ischemic ST-T changes in ECG possess important value in the diagnosis of the coronary artery diseases. The sensitivity of ECG in the diagnosis of myocardial ischemia in women was higher than that in men, whereas the specificity of ECG in the diagnosis of myocardial ischemia in men was higher than that in women.