老年人ST段水平延长对冠心病的诊断价值

The Diagnostic Value of Lengthened ST Level in Old Patients With Coronary Artery Diseases

目的:探讨老年疑似冠心病患者心电图中ST段水平延长≥0.12s在冠心病心肌缺血辅助检测中的作用,通过这一新的心电图学指标以提高冠心病诊断的效果。方法:184例老年疑似冠心病患者,其中ST段水平延长≥0.12s的老年患者100例(延长组),ST段<0.12 s老年患者84例(非延长组),均做冠状动脉造影。结果:冠状动脉造影阳性率与ST段是否延长差异有统计学意义(P<0.001)。延长组中,男性阳性者58例(93.5%),女性26例(68.4%),差异有统计学意义(P<0.01)。结果判断,延长组诊断冠心病的敏感性89%,特异性82%,阳性预测值84%,阴性预测值88%。结论:ST段水平延长≥0.12 s老年患者心肌缺血可能性大,ST段水平延长≥0.12 s可作为那些既不愿意做冠状动脉造影又不能做心脏负荷试验的老年人诊断冠心病的一个辅助指标。

Objective： To explore the diagnostic value of ST level length≥0. 12 s in electrocardiogram （ECG） in old patients with un- certain coronary artery disease （CAD） ,and to enhance the diagnostic accuracy of CAD through the new ECG auxiliary index. Methods： A total of 184 old patients with uncertain CAD treated in our hospital from 2006 to 2009 were studied. The patients were divided into two groups, Prolonged group, n = 100,the patients with ST level length t〉0. 12 s in ECG at the mean age of 67. 8 years, and Non-prolonged group, n = 84,the patients with ST level length 〈 0. 12 s at the mean age of 65.7 years. All patients re- ceived coronary angiography to confirm the authenticity of ECG screening. Results： Coronary angiography confirmed CAD （coronary stenosis ≥50% ） was significantly higher in Prolonged group than that in Non-prolonged group, P 〈 0. 001. In Prolonged group, the CAD diagnostic sensitivity, specificity, positive predictive value and negative predictive value were 89% ,82% ,84% and 88% respectively. Conclusion： ST level≥0. 12 s in ECG was closely related to coronary stenosis, it could imply the cardiac isehemia,therefore play an auxiliary role for CAD diagnosis in old patients who were neither willing to receive coronary angiography nor to take cardiac stress test.