动态心电图ST段趋势图对冠心病的临床诊断价值

The Value of ST Segment Trend Chart on Holter Monitoring in the Diagnosis of Coronary Artery Disease

目的参照冠状动脉造影检查,探讨动态心电图ST段趋势图的动态改变特征对冠心病的诊断价值.方法对动态心电图检查中发现缺血性ST段动态改变的患者155例,根据ST段趋势图特征改变,分为“城墙样”改变和“峰型”改变两组,均行冠状动脉造影检查,分析动态心电图ST段形态与心肌缺血的关系.结果155例缺血性ST段动态改变中,冠状动脉造影阳性92例,阳性率59.3%.97例ST段趋势图呈“峰型”改变者冠状动脉造影阳性87例,敏感度94.6%,特异度84.1%.58例ST段趋势图呈“城墙样”改变者,冠状动脉造影阳性5例,敏感度5.4%,特异度15.9%.结论动态心电图ST段趋势图呈“峰型”改变提示冠状动脉病变.

Objective To explore the value of ST segment trend chart （STSTC） change features on Holter in the diagnosis of coronary artery disease. Methods STSTC was categorized into peak shape and wall-like shape based on its features and coronary angiography was performed in 155 patients with ischemic ST changes on Holter. The relationships between STSTC and coronary artery stenosis were analyzed. Results Angiographic results were positive in 59.3% of all patients, in 87 of 97 cases with peak shape STSTC and in 5 of 58 cases with wall-like shape STSTC. In the diagnosis of coronary artery stenosis, the sensitivity and specificity of peak shape STSTC were 94.6% and 84.1%, respectively, while that of wall-like shape STSTC were 5.4% and 15.9%. Conclusions Peak shape STSTC on Holter implies significant coronary artery disease.