心磁图对冠心病患者的诊断价值

The diagnostic value of magnetocardiography to the patients with coronary heart disease

目的 探讨心磁图法对冠心病(CHD)患者的诊断价值,并与心电图(ECG)及超声心动图(UCG)作一比较。方法 应用非屏蔽室内的德国SQUID公司的7通道心磁图仪(MCG7),分别检测82例CHD患者(冠状动脉造影至少有一支血管狭窄≥70％)和116例健康人的心磁图和电流密度分布图,分析两个定量指标:①R-max/T-max比值:即电流密度分布图中R波与T波的最大电流密度矢量值的比值。②R值:异常的心磁图所占的百分比。结果 CHD组的R-max/T-max比值(6.17±4.01)显著高于健康对照组(3.73±1.41)(P<0.001);CHD组的R值为(67.27±28.75)％,对照组为(34.96±19.09)％,两组比较差异有显著性(P<0.001)。82例冠心病患者中,MCG出现异常改变的患者有67例(81.7％),ECG出现缺血改变(异常Q波及ST-T改变)的患者有37例(45.1％),超声心动图检出有节段性室壁活动异常的患者有34例(41.5％),心磁图对冠心病诊断的阳性率显著高于心电图及超声心动图(P<0.001)。结论 具有精细数据分析的心磁图对冠心病患者具有较高的诊断价值,且优于ECG及UCG。

Objective To evaluate the diagnostic value of magnetocardiography ( MCG) to the patients with coronary heart disease ( CHD) and compared MCG with ECG and UCG. Methods MCG measurements were performed in 101 patients with CHD and 116 healthy volunteers by means of the seven-channel MCG system (MCG7,SQUID AG,Germany) .installed in an unshielded room. CHD was diagnosed in case of stenosis ≥70% in≥one of main coronary branches. Two quantitative indicators were analyzed: R-max/T-max ratio, the ratio between the maxical magnetic value of R wave and T wave; R value, percentage of maps with additional current areas. Results R-max/T-max ratio of CHD group(6. 17±4. 01) was much higher than that of healthy group ( 3. 73±1. 41) (P < 0. 001) , R value of CHD group (67. 27±28. 75) % was much higher than that of healthy group (34. 96±19. 09) % (P < 0. 001). In 67 out of 82 CHD patients (81. 71% ) ,MCG had abnormal mapping patterns. The resting ECG examination showed ischemic changes, shch as an abnormal Q wave and ST-T change, in 37 patients (45. 12% ). Echocardiography revealed abnormal left ventricular wall motion, asynergy, in 34 patients (41. 46% ) . The diagnostic value of MCG for the patients with CHD was much higher than that of ECG and UCG( P < 0. 001). Conclusions Our work showed that resting MCG under condition of an advanced data analysis had higher diagnostic value and may be superior to ECG and UCG in patients with CHD. MCG could detect ST-segment displacement caused by ischemic myocardium and may be helpful to diagnose CHD early.