胸痛及心肌缺血患者心电图在冠心病诊断中的意义分析

Analysis on Significance of Electrocardiogram in the Diagnosis of Coronary Heart Disease in Patients with Chest Pain and Myocardial Ischemia

目的分析胸痛及心肌缺血患者心电图在冠心病诊断中的意义。方法选取我院2010年至2015年的冠脉造影病例120例,按照胸痛及心肌缺血心电图改变将其分为观察组(52例)和对照组(68例),并对两组患者进行15导联心电图检查,同时加做V_3R、V_4R、V_5R导联及冠脉造影,比较两组患者的胸痛、心肌缺血心电图,冠脉造影及诊断结果。结果观察组胸痛患者的灵敏度明显低于对照组,但其典型胸痛阳性预测值明显高于对照组(P<0.05);典型胸痛联合心肌缺血心电图的灵敏性和阳性预测值均高于非典型胸痛联合心肌缺血心电图(P<0.05)。结论典型胸痛心电图对冠心病的诊断具有较高特异性,而心肌缺血心电图对冠心病的诊断有着较高敏感性,故临床中诊断冠心病可依据典型胸痛联合心肌缺血心电图的检查结果。

Objective To analyze the significance of electrocardiogram in the diagnosis of coronary heart disease in patients withchest pain and myocardial ischemia. Methods 120 cases of patients undergoing coronary angiography in our hospital from 2010 to 2015were selected and divided into observation group （52 cases） and control group （68 cases） according to chest pain and myocardial ischemiaECG changes. And patients in two groups were given the 15 lead ECG examination as well as the V3R, V4R, VsR lead and coronaryangiography at the same time. The electrocardiogram, coronary angiography and diagnostic results of patients with chest pain, myocardialischemia in two groups were compared. Results The sensitivity of patients with chest pain in observation group was significantly lower thanthat of control group, but the positive predictive value of the typical chest pain was significantly higher than that of control group （P 〈0.05）.The sensitivity and positive predictive value of ECG in typical chest pain combined with myocardial ischemia were higher than those ofatypical chest pain combined with myocardial ischemia （P 〈0.05）. Conclusions The typical chest pain ECG has high specificity in thediagnosis of coronary heart disease, and the myocardial ischemia ECG has a high sensitivity to the diagnosis of coronary heart disease.Therefore, the clinical diagnosis of coronary heart disease can be based on the examination results of typical chest pain combined withmyocardial ischemia.