单纯心电图ST-T改变在老年患者冠心病诊断中的实际意义

目的评价心电图ST-T改变在诊断老年患者冠心病中的意义。方法选取2010年1月至2012年12月临床常规行心电图检查发现ST-T改变的患者180例,其中男90例,女90例,年龄60～86岁,平均(65.50±6.32)岁,70岁以上者136例(75.6%)。依据临床是否有典型心绞痛发作分为典型心绞痛组85例和不典型心绞痛组95例,所有患者入院前均在他院完成常规冠状动脉造影检查,入院后均积极完善各项常规检查,排除肝、肾等重要脏器疾患。结果典型心绞痛组中冠状动脉管腔直径狭窄≥50%者依据心电图检查ST-T改变,诊断阳性者为60例,心电图阳性检出率为70.59%;不典型心绞痛组冠状动脉管腔直径狭窄≥50%者依据心电图检查ST-T改变,诊断阳性者29例,心电图阳性检出率为30.52%。结论单纯心电图ST-T改变对诊断老年患者冠心病的临床实际价值不大,需通过进一步的检查来协助明确诊断,必要时行冠状动脉造影检查。

Actual significance of simple ECG ST-T changes in the diagnosis of elderly patients with coronary heart disease

Objective To evaluate the significance of ECG ST-T changes in elderly patients with coronary heart disease. Methods One hundred and eighty of patients with ST-T changes who were diagnosed by clinical routine ECG from January 2010 to December 2012 were selected, 90 cases were male and 90 cases were female, aged 60 -86 years, with an average （65.50 ± 6. 32） years old, 136 cases （75. 6% ） were more than 70 years old. Patients were divided into typical angina groups（85 cases） and atypical angina group （95 cases） according to the typical angina pectoris. All the patients were completed the conventional coronary angiography before they admitted to our hospital, and actively improved the routine examination after admission, exclu- ded vital organs such as liver, kidney disorders. Results In the typical angina gruop, based on ECG ST-T changes, the diagno- sis positive of patients with coronary luminal diameter stenosis 1〉 50% were 60 cases, and the ECG positive detection rate was 70. 59% ; And in the atypical angina group, based on the ECG ST-T changes, the diagnosis positive of patients with coronary lu- minal diameter stenosis 〉50%were 29 cases, and the ECG positive detection rate was 30. 52%. Conclusion Simple ECG ST- T changes has little actual value of clinical diagnosis of elderly patients with coronary heart disease, should be taking further checks to help confirm the diagnosis, if necessary, to coronary angiography.