静息心电图、经静脉心肌声学造影与冠脉造影诊断冠心病的对比分析

The comparative analysis of resting electrocardiogram and intravenous myocardial contrast coronary angiography for the diagnosis of heart disease

目的探讨静息心电图（EcG）、经静脉心肌声学造影（MCE）对冠心病的诊断价值及相关病变血管部位的敏感性、特异性、准确性。方法2009年5月－2010年11月滨州市人民医院心血管内科收治的78例患者，男女各39例，同期（〈2周）内行静息心电图、心肌声学造影及冠状动脉造影检查。结果MCE诊断冠心病的敏感性与静息ECG、静息ECG＋MCE相比差异有显著性（P〈0．05）。静息ECG＋MCE诊断冠心病的特异性与静息ECG、MCE相比差异有显著性（P〈0．05）。MCE与静息ECG、静息ECG＋MCE在推测LAD、LCX的敏感性上相比差异有显著性（P〈0．05）。静息ECG＋MCE在推测LAD、LCX的特异性上与静息ECG、MCE相比差异有显著性垆〈0．05）。静息ECG、MCE、静息ECG＋MCE对推测RCA的敏感性、特异性、准确性上相互比较差异无显著性（P〉0．05）。结论静息ECG在诊断冠心病及其相关病变血管的判定方面有一定的局限性。MCE对冠心病及其冠状动脉LAD、LCX的判定有较高的敏感性；静息ECG＋MCE在排除冠心病及LAD、LCX病变方面有一定的参考价值。CAG是诊断冠心病的“金标准”，目前仍是不可取代的冠心病的诊断方法。

Objective To explore the diagnostic value of resting electrocardiogram （ECG） and intravenous myocardial contrast echocardiography （MCE） for the diagnosis of coronary heart disease and vascular lesions associated sites of the sensitivity, specificity and accuracy. Methods May 2009 to November 2010, selected 78 patients, 39 ones were male and the others were female, aged f45-75, the average age was （50.8 ± 12.9） years （excluding cardiomyopathy, Hypertensive heart disease and diabetes） from the Department of Cardiology at Binzhou People＇ s Hospital. 22 cases were diagnosed with coronary heart disease conbined with myocardial infarction, 13 cases with angina pectoris （including one case of variant angina）, 23 cases were suspected with coronary artery disease, 20 cases with unknown chest pain. The same period （〈2 weeks）, carried out resting Electrocardiogram and cardiac ultrasound contrast and coronary on them. Results 1. There was statistically significant difference among MCE diagnosis of coronary artery disease susceptibility, resting ECG, and resting ECG ＋ MCE （P〈0.05）. There was statistically significant difference between resting ECG ＋ MCE specific diagnosis of coronary artery disease and resting ECG, MCE e （P〈0.05）. 2. Using MCE, resting ECG, and resting ECG ＋ MCE to speculate LAD, LCX had higher sensitivity（P〈0.05）. There was statistically significant difference on the specificity between using resting ECG ＋ MCE to speculate LAD, LCX and using resting ECG, MCE （P〈0.05）. 3. Among resting ECG, MCE, resting ECG ＋ MCE RCA speculating on the sensitivity, specificity, and accuracy, the difference was not significant （P〉 0.05）. Conclusion 1. Resting ECG for the diagnosis of coronary heart disease and vascular diseases related to the judge has some limitations. 2. MCE for the determination of coronary heart disease and coronary artery LAD, LCX has a higher sensitivity. 3. Resting ECG ＋ MCE for the exclusion of coronary heart disease and LAD, LCX lesions has some reference value. 4. CAG for the diagnosis of coronary artery disease is the ＂gold standard＂; it still is an irreplaceable method for the diagnosis of coronary heart disease.