立体心电图对冠心病心肌缺血的诊断价值

Value of stereocardiogramin diagnosing myocardial ischemia of coronary heart disease

目的以冠状动脉造影结果作为金标准,对比分析常规12导联心电图(ECG)、向量心电图(VCG)、立体心电图(SECG)等检查对诊断冠心病心肌缺血的敏感性,评价SECG在冠心病心肌缺血诊断中的价值。方法选择156例行冠脉造影(CAG)的患者,其中冠心病组103例,非冠心病组53例,分析其于同一心电工作站所做的ECG、VCG、SECG资料,观察比较这三种方法的检出结果。结果 SECG在诊断冠心病心肌缺血方面,检出率高于VCG、ECG,差异有统计学意义(P<0.05);SECG在诊断冠心病心肌缺血方面的灵敏度、特异度、正确指数、诊断符合率均高于VCG、ECG;SECG在诊断冠心病冠脉多支病变上与ECG、VCG无差异,在一支病变及两支病变上与ECG相比差异有统计学意义(P<0.05),检出率较ECG明显增高,而与VCG相比差异无统计学意义(P>0.05);SECG在诊断冠心病Ⅱ~Ⅲ级狭窄组中检出率较ECG明显增高(P<0.05),但与VCG相比差异无统计学意义;在完全闭塞组中,虽然SECG检出率较VCG、ECG高,但结果差异无统计学意义(P>0.05)。结论SECG在诊断冠心病心肌缺血有一定的诊断价值,且优于VCG、ECG。

Objective To evaluate the value of the stereo cardiogram( SECG) in diagnosing myocardial ischemia of coronary heart disease( CHD) by comparing and analyzing,on the basis of the gold standard of coronary angiography( CAG) results the sensitivity of the conventional 12-lead electrocardiogram( ECG),vector diagram( VCG) and SECG in the diagnosis of myocardial ischemia of CHD.Methods One hundred and fifty-six patients who underwent CAG were collected and assigned randomly into the CHD group( 103 patients) and the N-CHD group( 53 patients). In the same ECG workstation,the detection results of ECG,VCG and SECG were analyzed and compared. Results The detection rate of SECG in the diagnosis of myocardial ischemia of CHD was higher than VCG and ECG;the result was statistically significant( P < 0. 05). The sensitivity,specificity,index,the correct diagnosis coincidence rate of SECG diagnosing myocardial ischemia of CHD were higher than those of VCG and ECG. There was no difference between SECG and VCG,ECG in the diagnosis of coronary multivessel lesions,while there was significant difference between SECG and ECG in the diagnosis of one coronary lesionand two coronary lesions( P < 0. 05); the detection rate of SECG was significantly higher than that of ECG,but there was no statisticaldifference between SECG and VCG. The detection rate of SECG in the diagnosis of coronary stenosis level Ⅱ and Ⅲ group was significantly higher than that of ECG( P < 0. 05),but there was no statistical difference between SECG and VCG. In diagnosing coronary total occlusion group,the detection rate of SECG was higher than that of VCG or ECG,but the results had no statistically significant difference( P > 0. 05). Conclusions SECG in the diagnosis of myocardial ischemia of CHD had a certain value,and was better than VCG and ECG.