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目的：比较冠状动脉造影与动态心电图监测在老年冠心病患者中的诊断效能。方法选取2013年6月—2014年5月在心内科就诊的71例老年胸闷症状患者为研究对象，进行冠状动脉造影和动态心电图监测。结果71例患者中，冠脉造影检出冠心病阳性患者60例，冠心病阴性11例；动态心电图检出冠心病阳性49例（含4例假阳性），冠心病阴性22例（含假阴性7例）。以冠脉造影为“金标准”，动态心电图诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为75.00%（45/60）、63.64%（7/11）、73.24%（52/71）、91.84%（45/49）、31.82%（7/22）；单支病变组、双支病变组、三支及以上病变组的动态心电图ST段压低率分别为83.33%、80.00%、81.82%，组间差异无统计学意义（P﹤0.05）。结论动态心电图诊断冠心病的诊断效能低下，但是动态心电图在检测冠心病心律失常方面有一定的价值，值得在基层医院推广应用。“,”Objective To compare the dynamic electrocardiogram (ECG) and coronary angiography diagnostic efficacy monitoring in elderly patients with coronary heart disease (CHD).Methods From June 2013 to May 2014, 71 cases of senile chest symptoms were selected as the research object, in the Department of Cardiology in our hospital for treatment of coronary angiography and dynamic ECG monitoring.Results 60 cases with CHD were positive, 11 cases with negative CHD; dynamic ECG detection of CHD was positive in 49 cases (including 4 false positive) and negative CHD 22 cases (including 7 cases was false negative). In coronary angiography as a “gold standard”, dynamic ECG diagnostic sensitivity, speciifcity, accuracy, positive predictive value, negative predictive value were 75.00% (45/60), 63.64% (7/11), 73.24% (52/71), 91.84% (45/49), 31.82% (7/22); single vessel lesion group, double vessel lesion group and more than three vessel lesion group dynamic ECG ST segment depression rates were 83.33%, 80.00%, 81.82%, the difference has no statistical signiifcance (P﹤0.05).Conclusion Dynamic ECG diagnosis CHD diagnosis efficiency is low, if there is no coronary angiography in primary hospital, ambulatory ECG should be sent to the superior hospital referral.