ST-T异常拟诊为冠心病冠状动脉造影阴性98例分析

Clinical Analysis of 98 Patients with ST-T Changes Clinically Suspected Coronary Heart Disease but Angiographically Normal

目的探讨心电图异常而冠状动脉造影阴性患者的临床特点。方法对98例冠状动脉造影阴性而心电图表现为ST-T改变的临床拟诊为冠心病的患者进行回顾性分析。结果典型胸痛39例,占39.80%,有家族史、吸烟史者较少(分别为27.55%和22.45%)临床化验大多正常,临床检查复杂多样,临床合并症较多,前3位分别为高脂血症、高血压病和心律失常。心电图均有不同程度的ST-T改变,但缺乏特征性,冠状动脉有30.61%不完全正常,最后诊断以冠心病居多,高血压病次之,含糊性诊断占一定比例。结论心电图诊断冠心病有一定局限性,但简便、安全、有效,冠状动脉造影应予推广,冠心病的诊断应综合考虑。

Objective To explore the clinical characters of patients with ST-T changes while angiographically normal. Methods Retrospective analysis was performed in 98 patients with ST-T changes clinically suspected coronary heart disease（CHD）but angiographically normal. Results Those with typical chest pain accounted for 39.80%;The family history and cigarette-smoking history were low, accounted for 27.55% and 22.45% of 98 total cases respectively. Most of the lab-data was normal while the clinical examination was just the opposite; The association with hyperlipemia, hypertension, and arrhythmia was high; The ST-T changes of electrocardiogram to varying degrees were found in all patients, but lack of the typical electrocardiographic CHD characters; Of all the 98 cases, there are still about 30 patients （30.61%）whose coronary arteries were not completely normal; In the final diagnosis, CHD was the first, hypertension, was the second, ambiguous diagnosis remains its place. Conclusion ECG criteria for diagnosing CHD is relative, but electrocardiogram itself is easy, safe and effective; Because of its excellence, we should do our utmost spread the technology of CAG. In order to diagnose CHD more exactly, of course, the final diagnosis for CHD should be considered in comprehensive survey.