冠心病患者心电图ST段水平延长与冠状动脉狭窄程度的相关性及诊断价值

The Correlation between ST Segment Horizontal Elongation and Coronary Arteries Occlusion (stenosis) and Value in the Diagnosis of CAD

本文对冠心病患者的心电图多项指标检测与冠状动脉造影对比 ,来探索ST段水平延长≥ 0 .12s对冠心病诊断的价值。对 334例冠心病患者进行心电图检查并与冠状动脉造影进行对比 ,发现ST段水平延长≥ 0 .12s,对冠心病诊断的敏感性优于ST段水平下移和缺血T波。在冠状动脉轻度病变中 ,敏感性分别是 5 1%、4 1%和 38% ;中度病变中是 75 %、5 2 %和 5 6 % ;三者之间比较有显著性差异 (P <0 .0 1) ;重度病变中的敏感性无显著性差异 (P >0 .0 5 )。此外 ,ST段水平延长≥ 0 .12s与冠状动脉造影各支冠状动脉病变特征进行对比发现 :在单支和多支病变患者中 ,当狭窄 <90 %时阳性率是 4 7%和 6 9% ;狭窄 >90 %时 ,阳性率是 73%和 10 0 %。两者之间比较有显著性差异(P <0 .0 1)。说明ST段水平延长≥ 0 .12s对冠心病诊断的敏感性高 ,可以作为早期诊断的指标之一 ,对冠心病病变严重程度的评价亦有价值。

Aim To compare multiple ECG testing measurements with coronary angiography and study the diagnostic ability of ST segment horizon tal elongation on the coronary stenosis severity. Methods CAG and ECG were performed in 334 cases respectively. Results Sensitivity of diagnosing CAG of ST segment horizontal elongtion (≥0.12 s) is superior to ST segment depression and ischemic T waves. In mild, moderate and severe CAD cases, the comparison of the sensitivity is as follows:51%vs41%,38%; 75%vs 52%,56%(P<0.01);100% vs 96%, 100%(P>0.05). Moreover,comparison between ST segment horizontal elongation (≥0.12 s) and CAG demonstrated: When the stenosis is less than 90% in both single and multiple coronary arteries disease, the positive rate is 47%,68%; When the stenosis is more than 90% in both single and multiple coronary arteries disease, the positive rate is 73%,100%.(P<0.01) The difference is significant between them. Conclusion The prolongation of ST segment may not only serve as one of marks for the diagnosis of early CAD because of its higher sensitivity but also be used for the anglysis of the severity of coronary stenosis because of its important values to detect severe CAD.