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目的 通过对 178例拟诊冠心病患者的静息心电图 (ECG)与冠状动脉造影结果进行回顾性分析 ,评价静息心电图 (ECG)对冠心病诊断和预后的价值。方法 选择有冠心病典型症状及危险因素的患者 ,男 10 9例、女 6 9例 ,年龄 6 2 .5 (6 1.5± 11.1)岁。其中 ,99例患者ECG有心肌缺血表现 (ECG阳性组 ) ,79例无心肌缺血表现 (ECG阴性组 )。对所有拟诊患者进行冠状动脉造影 (CAG)检查。结果 静息ECG阳性与阴性组患者 ,CAG阳性率无显著性差异 (5 4 .5 %vs 5 9.5 % ,P >0 .0 5 ) ;静息ECG对冠心病诊断的敏感性为 5 6 .4 % ,特异性为 36 .8% ;静息ECG阳性组多支病变率明显高于ECG阴性组 (6 6 .7%vs 4 4 .7% ,P =0 .0 2 9) ;静息ECG阴性组单支病变率明显高于ECG阳性组 (5 5 .3%vs 33.3% ,P =0 .0 2 6 )。静息ECG阳性组高血压患病率明显高于ECG阴性组 (P =0 .0 4 2 )。结论 静息ECG阳性对诊断冠心病的特异性和敏感性低 ,对多支、多危险因素的高危冠心病患者具有一定的提示意义。
Objective To evaluate the value of resting electrocardiogram (ECG) in the diagnosis and prognosis of coronary heart disease by retrospectively analyzing resting electrocardiogram (ECG) and coronary angiography in 178 patients diagnosed with coronary heart disease. Methods The patients with typical symptoms and risk factors of coronary heart disease were enrolled in this study. There were 109 males and 69 females, aged 62.5 (6 1.5 ± 11.1) years old. Among them, ECG of 99 patients showed myocardial ischemia (ECG positive group), 79 patients showed no myocardial ischemia (ECG negative group). Coronary angiography (CAG) was performed on all patients who were diagnosed. Results There was no significant difference in the positive rate of CAG between resting ECG positive and negative groups (54.5% vs 5 9.5%, P> 0.05). The sensitivity of resting ECG to diagnosis of coronary heart disease was 56. 4%, and specificity of 36.8%. The multi-vessel disease rate of resting ECG positive group was significantly higher than that of ECG negative group (6.6% vs.44.7%, P = 0.029) The single-vessel lesion rate in ECG-negative group was significantly higher than that in ECG-positive group (35.3% vs 33.3%, P = 0.026). The prevalence of hypertension in resting ECG positive group was significantly higher than that in ECG negative group (P = 0.042). Conclusions The resting ECG positive is low specificity and sensitivity in diagnosis of coronary heart disease, which is of great significance to patients with multi-branch and multi-risk factors of high-risk coronary heart disease.