动态心电图检出缺血性ST段下移的临床意义

Clinical Significance of ST-segment Depression in Dynamic Electrocardiogram

目的 探讨动态心电图ST段下移对冠心病的诊断意义和价值。方法 对 41例胸痛患者进行DCG及冠脉造影检查。结果 10例正常冠状动脉患者DCG检查显示心肌缺血 1例 ,特异性为 90 % ,冠状动脉病变 3 1例中显示心肌缺血 2 0例 ,敏感性为65 % ,心肌缺血检出的敏感性与冠状动脉病变程度有关 ,多支病变为 78% ,单支病变为 46% (P <0 .0 5 )。结论 DCG检查对多支病变患者检出缺血性ST段下移的敏感性明显高于单支病变患者 ,对有典型心绞痛症状 ,DCG检出有缺血性ST段下移即使冠脉造影正常 ,也应视为冠心病。

Objective To investigate the significance of ST-segment depression in dynamic electrocardiogram(DEG) for diagnosing coronary heart disease. Methods DEG and coronary arteriongraphy were detected in 41 patients with chest pain. Results Myocardial ischemia appeared in DEG in 10 persons without coronary heart disease. The specificity was 90%. Myocardial ischemia appeared in DEG in 31 patients with coronary artery disease. The sensibility was 65%. And the sensibility was related to the degree of coronary artery disease. It was 78% with multi-vessel lesion, and it was 46% with mono-sessel lesion. Conclusions The sensibility of ST-segment depression in DEG in multi-vessel lesion was higher than in mono-vessel lesion. If the patients with typical angina appeared ST-segment depression in DCG, they should be considered as patients with coronary heart disease, despite of the negative of coronary arteriongraphy.