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目的:评价普通心电图和动态心电图在无症状性冠心病中的诊断价值。方法:纳入行冠脉造影的疑诊冠心病患者,术前完善普通心电图及动态心电图检查,对其价值进行比较分析。结果:677例冠心病患者中,无症状性冠心病175例。其中常规心电图诊断为心肌缺血阳性者95例(54.3%),动态心电图诊断为心肌缺血阳性者129例(73.7%),动态心电图诊断阳性率明显高于普通心电图(P<0.01)。普通心电图显示无症状性心肌缺血的173例患者中,最终确诊冠心病118例(68.2%),动态心电图显示无症状性心肌缺血的193例患者中,最终确诊冠心病147例(76.2%),动态心电图心肌缺血对诊断冠心病的特异性明显高于普通心电图(P<0.05)。结论:无症状性冠心病较为常见,动态心电图提高了其检出率.同时动态心电图发现的心肌缺血表现对冠心病具有较高的预测价值。
Objective: To evaluate the diagnostic value of common electrocardiogram and ambulatory electrocardiogram in asymptomatic coronary heart disease. Methods: Patients with suspected coronary artery disease who underwent coronary angiography were enrolled in the study. The general electrocardiogram and dynamic electrocardiogram were performed preoperatively to compare their values. Results: Of the 677 patients with coronary heart disease, 175 patients had asymptomatic coronary heart disease. 95 cases (54.3%) were diagnosed as myocardial ischemia by conventional electrocardiogram, 129 cases (73.7%) were diagnosed as myocardial ischemia by dynamic electrocardiogram, the positive rate of Holter diagnosis was significantly higher than that of general electrocardiogram (P <0.01). Among the 173 patients with asymptomatic myocardial ischemia in the general electrocardiogram, 118 patients (68.2%) were diagnosed with coronary heart disease and 147 patients (76.2%) were diagnosed with coronary heart disease by dynamic electrocardiogram. Of the 193 patients with asymptomatic myocardial ischemia, ), The specificity of dynamic electrocardiogram myocardial ischemia in diagnosis of coronary heart disease was significantly higher than that of general electrocardiogram (P <0.05). Conclusions: Asymptomatic coronary heart disease is more common, and the dynamic electrocardiogram improves the detection rate.At the same time, the myocardial ischemia manifestations of ambulatory electrocardiogram have a higher predictive value for coronary heart disease.