临床症状及心电图对冠心病诊断价值的性别差异

Different diagnostic value of clinical characteristics and electrocardiogram between male and female patients with coronary heart disease

目的:分析不同性别患者临床症状及心电图改变对冠心病诊断价值的差异.方法:采用配对设计,比较临床症状及心电图改变对冠心病诊断价值的性别差异,并比较男女冠心病患者冠状动脉病变的程度.结果:依据典型胸痛诊断女性冠心病敏感性50.4%,特异性71.3%,准确率68.5%;诊断男性冠心病敏感性62.2%,特异性63.4%,准确率80.3%;依据心电图ST段改变,诊断女性冠心病准确率为80.4%,男性为85.2%;男女两组冠状动脉病变程度无统计学差异(P>0.05).结论:根据典型胸痛及心电图ST段改变诊断冠心病,在男女均具有较高准确性,但典型胸痛症状对女性冠心病的诊断价值较男性低;绝经后女性冠状动脉病变程度与男性相似.

AIM： To study the different diagnostic value of clinical characteristics and electrocardiogram between male and female patients with coronary heart disease. METHODS： We compared the clinical syndromes, electrocardiogram change and coronary disease severity between female and male patients by matchedpairs design. RESULTS： 68.5% female patients with typical chest pain were diagnosed with coronary heart disease, while 80. 3% male patients with typical chest pain was diagnosed with coronary heart disease; 80.4% male patients with electrocardiogram change in ST segment were diagnosed with coronary heart disease and 85.2% male patients with electrocardiogram change in ST segment were diagnosed with coronary heart disease. The degree of coronary disease was not statistically different between women and men. CONCLUSION： It is reliable to diagnose coronary heart disease by typical chest pain and ST segment change, but typical chest pain has more diagnosic value for male. The degree in coronary disease is similar in women and men.