心电图ST-T改变对冠状动脉狭窄的诊断价值

Diagnostic Value of the ST-T Change on ECG in Coronary Artery Stenosis

目的探讨心电图(ECG)ST-T改变在冠状动脉狭窄病变中的诊断价值。方法选择疑似冠心病患者资料360例,根据冠状动脉造影(CAG)结果分为CAG阳性组、CAG阴性组,CAG阳性组又根据狭窄血管多少分为单支组和多支组,回顾性分析ECG ST-T改变与CAG结果之间的关系。结果单支病变组、多支病变组与CAG阴性组比较,差异有显著性(P<0.05),单支组与多支组比较差异显著(P<0.05);CAG阳性但ECG ST-T正常患者中,单支血管病变为26例,2支血管病变为60例,三支及三支以上血管病变11例。CAG阴性但ST段异常患者中,病因包括扩张型心肌病、肥厚型心肌病、硬皮病性心肌病、十二指肠球部溃疡及返流性食管炎、先心病、贫血等。结论ECG ST-T段改变可以预测冠状动脉狭窄,对于多支组具有更明显的意义,但需要结合临床表现及其他检查和实验室酶学指标进行诊断。

Objective To discuss the diagnostic value of the ST - T change on ECG in coronary artery stenosis. Methods 360 patients with coronary heart disease （CHD） were studied. They were divided into positive group and negative group according to the results of coronary angiog- raphy （CAG）. The positive CAG group were divide into single -vessel group and multi- vessel group. The relation between ECG ST -T change and results of CAG were analyzed. Results There were significant difference between the negative group and the positive group （P 〈 0. 05）. And there was significantly statistical difference between patients with single - vessel lesion and mutil- vessel lesion（P 〈0. 05）. In the patients with positive CAG and normal ECG ST group, 26 cases were with single - vessel lesion, 60 cases were with double - vessel lesion, 11 cases were with poly -vessel lesion. In the negative CAG and abnormal ECG ST group, the disease cause include dilated cardiomyopathy, hypertrophic cardiomyopathy, scleroderma cardiomyopathy, duodenal ulcer, reflux esophagitis, congenital heart disease, anaemia. Conclusion The ST -change on ECG may partially predict the coronary artery stenosis,and has more obvious meaning to multi -vessel group especially, but the diagnosis must base on clinical symptom and other examination and laboratory enzyme index.