临床心电图和外周血管超声对冠状动脉病变预测价值的临床研究

目的 探讨心电图和外周血管超声对冠状动脉病变的预测价值.方法 回顾性分析168例冠心病患者联合心电图和外周血管超声与冠状动脉造影（CAG） 资料.根据CAG确定病变范围,通过分析心电图,多导联ST-T改变,如aVR 导联ST 段抬高＞0.05 mV,且合并≥6个导联ST段压低（幅度越大预测性越高）或aVR导联ST 抬高大于V1导联ST 段抬高,联合颈动脉和股动脉超声检测,提示外周动脉硬化积分与冠状动脉硬化狭窄积分呈正相关.结果 ①多支病变组心电图改变特点与非多支病变组差异有统计学意义（P＜0.05）.②与非冠心病组比较,冠心病组颈股动脉内膜增厚和斑块形成率增高（P＜0.05）.冠状动脉多支病变组颈股动脉斑块形成率高于其他两组（P＜0.05）.③冠状动脉多支病变组颈股动脉粥样硬化IMT与对照组比较差异有统计学意义（P＜0.01）,与单支病变组比较差异亦有统计学意义（P＜0.05）.结论 联合心电图和外周血管超声检测预测冠状动脉多支血管病变、左主干病变准确性高,临床检测方便,适合基层推广.

Predictive value of electrocardiogram and peripheral vascular ultrasound for coronary artery disease

Objective To study the predictive value of ECG and peripheral vascular ultrasound for coronary artery disease. Methods The peripheral vascular ultrasound, ECG and coronary angiography （CAG） data were analyzed in 122 cases with coronary heart disease retrospectively. The extent of disease was determined according to CAG. The relationship of the characteristics of electrocardiogram （including lead aVR ST-segment elevation 〉0.05 mV, combined ≥6-1ead ST-segment depression or lead aVR ST elevation 〉V1 ST-segment elevation）, carotid and femoral artery ultrasound and coronary artery stenosis was analyzed. Results （1）There was sig- nificantly different in ECG between muhivessel disease group and non-multivessel disease group （P〈0.05）. （2）Tbe intimal thickening and rate of artery plaques formation in carotid and femoral artery was significantly higher in coronary heart disease （CHD） group than non-coronary heart disease （NCHD） group （P〈0.05）. （3）In coronary artery multivessel disease group, the IMT was significantly different with controls（P〈0.01 ） and single vessel lesion group （P〈0.05）. Conclusion Combined ECG and peripheral vascular ultrasound, the predictive value for coronary artery disease with multi-vessel lesions and left main artery lesion is high accuracy, and suitable promotion in basic hospital.