运动试验中不同心电图指标诊断价值的比较

Comparison of Diagnosis Values Among Different ECG Parameters on Myocardial Ischemia.

为探讨心电图多参数联合诊断方法，观察了２１例活动平板运动试验阳性和可疑阳性者的ＳＴ段，ＳＴ／ＨＲ指数，ＱＴｃ及△Ｒ波振幅等参数的变化情况，并对其进行静息和运动心肌灌注ＳＰＥＣＴ检查，探讨了心电图多参数指标对心肌缺血的诊断价值。结果表明：ＳＴ段及ＳＴ／ＨＲ指数的敏感性和特异性均高于另外两个指标，而且其阳性检出率在ＳＰＥＣＴ阳性组与阴性组间有显著性差异（Ｐ＜０．０５）。将几个参数联合诊断心肌缺血，可最大程度地减低误诊率，优于任何单一指标。

In order to determine the value of ECG in predicting coronary artery diseases,four clinical indices of ECG:ST segment,Q Tc interval,△R(exercise induced R wave amplitude changes) and ST/HR index during treadmill test were studied in 21 cases aged 35～55(average 47.6yr). SPECT was also done during the test.21 cases were divided into positive group and negative group according to SPECT test. The results showed that basing on this classification, ST segment and ST/HR index are superior to the other two in differentiating positives and negatives: ST (85.7% versus 35.7% , P<0.05); ST/HR index (100% versus 42.8%, P<0.05);△R ( 71.4% versus 50.0%,P>0.05 );Q Tc ( 57.1 % versus 64.3 % , P>0.05 ).If the four indices were used together as a combied one, it will be more reliable than any of the single ones, and may provide an accurate method for noninvasive detection of coronary artery diseases.