早期冠心病诊断标准的探索

STUDY ON THE DIAGNOSIS STANDARD OFEARLY CHO

本文通过４０例具有冠心病易患因素，血浆胆固醇水平升高，并拟诊为早期冠心病的患者进行了常规心电图与高频心电图的对比观察，发现ＨＦＥＣＧ的检出率明显高于常规心电图，两者分别为７７．５％和２０％。同时将２０只家兔分为两组，实验组动物饲以高脂饲料，对照组给以一般颗粒饲料。在实验过程中连续观察血浆胆固醇水平，ＨＦＥＣＧ及常规ＥＣＧ的动态变化。最后发现实验组动物的主动脉内形成粥样硬化斑块，但是未发现明显冠状动脉狭窄。在实验组中还发现血浆胆固醇水平，ＨＦＥｃＧ的阳性率均呈逐渐升高的趋势，而常规心电图无变化。经过对上述患者与实验动物的观察，认为等冠状动脉狭窄至严重程度，并产生明显心绞痛发作及ＥＣＧ表现为阳性时，会失去良好的预防时机，使医生处于非常被动的地位。在存在显著冠心病易患因素的患者中，如果一旦发现血浆胆固醇水平升高，以及ＨＦＥＣＧ阳性时，就应考虑为早期冠心病予以积极防治，以期达到延缓或杜绝严重冠状动脉狭窄发生的目的。

The changes of ECG and high frequency electrocar-diogram (HFECG)in 40 patients with early coronary heartdisease ( CHD )were examined.The positive rate ofHFECG and ECG was 77.5%and 20% respectively.Twenty rabbits were allocated in two groups.In the testgroup,the rabbits were fed with high fat diet;while in thecontrol group the rabbits were fed with general diet.Theplasma cholesterol,ECG and HFECG were determined con-tiously during the test period.In the test group theatherosclerotic plaque was formed at the aortic intimal sur-face,but Without serious coronarv stenosis.The plasmacholesterol level and positive rate of HFECG were raisedgradually,while ECG changes were not found. The resultsindicated that,when coronary stenosis formed, angina pec-toris appeared ,and positive changes of ECG were found,the good chance for preventing CHD would be lost.It wassuggested to prevent CHD earlier,when the plasma choles-terol level was high and positive HFECG was found in thepatients with CHD susceptible factors.