体表电位标测、心电图和高频心电图诊断冠心病价值的对比研究

Comparative diagnostic value of body surface potential mapping,ECG and high frequency ECG on coronary heart disease

目的 :比较体表电位标测 (BSPM)、心电图 (ECG)和高频心电图 (HFECG)三种心电方法对冠心病 (CHD)的诊断价值。方法 :使用 BSPM- 型体表电位标测微机系统 ,对冠脉造影确诊的 60例 CHD患者和 60例正常人进行BSPM,并分析 T峰值图图形和极小值位置的变化。同时记录 ECG和 HFECG,并由专业人员盲法分析其变化 ,评价三种方法的诊断价值。结果 :ECG,HFECG和 BSPM诊断的敏感度分别为 67% ,87%和 85 % ,特异度分别为63% ,75 %和 90 % ,准确度分别为 65 % ,81%和 88%。诊断的敏感度 HFECG和 BSPM均显著高于 ECG(P<0 .0 5 ) ,特异度 HFECG与 ECG无差别 (P>0 .0 5 ) ,而 BSPM非常显著高于 ECG(P<0 .0 1) ,也显著高于 HFECG(P<0 .0 5 )。结论 :ECG诊断 CHD的敏感度和特异度都较低 ,HFECG能提高敏感度 ,而 BSPM既能提高敏感度 ,又能提高特异度 ,BSPM是一种价值较高的 CHD诊断方法。

AIM:To compare the diagnostic value of body surface potential mapping (BSPM) and electrocardiogram(ECG) and high frequency ECG(HFECG) for coronary heart disease(CHD). METHODS: BSPM was undertaken in 60 normals and 60 patients with CHD confirmed by coronary angiography using BSPM Ⅲ computer system. Changes of morphology and location of minimal values in T peak potential map were analyzed. ECG and HFECG were also recorded and analyzed by specialist. Diagnostic value of 3 electrocardiographic methods was evaluated. RESULTS: Sensitivity of ECG, HFECG and BSPM was respectively 67%, 87% and 85%, specificity was respectively 63%, 75% and 90%, accuracy was respectively 65%, 80% and 88%. Sensitivity of HFECG and BSPM was significantly higher than that of ECG. Specificity of HFECG and ECG was no significantly different( P >0.05), but that of BSPM was significantly higher than that of ECG( P <0.01) and HFECG ( P <0.05) also. CONCLUSION: The sensitivity and specificity of ECG to CHD are relatively low whereas HFECG can improve this sensitivity, and BSPM can improve not only the sensitivity and but also the specificity. Therefore, BSPM was a diagnostic method of higher value for CHD.