18导联心电图对中老年冠心病患者的诊断价值探讨

Diagnostic Value of 18 Lead ECG in Middle Aged and Old Aged Patients with Coronary Heart Disease

目的:比较12及18导联心电图(ECG)对中老年冠心病(CHD)的诊断价值。方法:204例心内科就诊患者行12导联及18导联心电图检查,观察ST段、Q波及T波对是否对CHD作出初步诊断,204例患者心电图检查后行冠脉造影检查,观察各主要冠脉血管狭窄程度,狭窄≥50%为阳性,<50%为阴性,将2种导联心电图结果与冠脉血流结果进行比较,评价2种心电图在诊断中老年CHD中的价值。结果:18导联ECG比12导联ECG有更高的诊断CHD的敏感度和特异度,差异有统计学意义(P<0.05);18导联ECG比12导联ECG在诊断左冠状动脉回旋支单支病变、合并三支(左前降支、左回旋支和右冠状动脉)病变有更高的敏感度,差异有统计学意义(P<0.05);在诊断右冠状动脉、左冠状动脉前降支病变2种导联ECG比较,差异无统计学意义(P>0.05)。结论:18导联ECG较12导联ECG具有更高的诊断CHD的价值,尤其是对于LCX病变以及三支病变的中老年CHD患者。

Objective： To compare the diagnostic value between 12 lead electrocardiogram （ECG） and 12 lead electrocardiogram among middle aged and old aged patients with coronary heart disease （CHD）. Methods： 204 patients in department of cardiology received 12 lead and 18 lead ECG exami- nations. The tentative diagnosis was obtained on the basis of observing the ST segment, Q wave and T wave. Then, 204 patients received coronary angiography examination, and the degree of stenosis of major coronary vessels was observed. Stenosis greater or equal to 50% was positive and stenosis less than 50% negative. The results of two kinds of lead ECG were compared with the results of coronary flow, and the value of two kinds of lead ECG in the diagnosis of CHD among middle aged and aging patients was evaluated. Results： 18 lead ECG had a significantly higher sensitivity and specificity than those in 12 lead ECG in diagnosis of patients with CHD （P 〈0.05）. 18 lead ECG had a significantly higher sensitivity than that in 12 lead ECG in diagnosis of patients with LCX stenosis and multiple coro- nary artery （P 〈 0.05 ）. 18 lead ECG has no significant difference in the sensitivity compared with that in 12 lead ECG in diagnosis patients with RCA stenosis and LAD stenosis. Conclusion： 18 lead ECG is more valuable than 12 lead ECG in diagnosis of middle aged and old aged patients with CHD, espe- cially with LCX stenosis and multiple coronary artery stenosis.