静息心电图在鉴别诊断CHD不同病情患者中的临床应用价值

The Clinical Value of Resting Electrocardiogram in the Differential Diagnosis of CHD Patients with Different Diseases

目的探讨静息心电图检查在鉴别诊断冠心病(CHD)患者中的临床价值。方法选取白银市第一人民医院收治的初步诊断为CHD的患者247例,均接受静息心电图、冠脉造影检查,以冠脉造影检查结果作为诊断金标准,分别计算不同冠脉病变支数、不同冠脉狭窄程度的CHD患者采用静息心电图诊断的临床价值。结果 247例患者中,冠脉造影检查确诊187例CHD患者,非CHD患者60例。心电图诊断CHD的灵敏度为72.19%,特异度为56.67%,漏诊率为27.81%,误诊率为43.33%,阳性预测值为83.85%,阴性预测值为39.53%;心电图诊断CHD单支病变患者的灵敏度为51.92%,特异度为56.67%;心电图诊断CHD双支病变患者的灵敏度为74.07%,特异度为56.67%;心电图诊断CHD三支病变患者的灵敏度为87.04%,特异度为56.67%;心电图诊断CHD轻度狭窄患者的灵敏度为42.65%,特异度为56.67%;心电图诊断CHD中度狭窄患者的灵敏度为74.03%;特异度为56.67%;心电图诊断CHD重度狭窄患者的灵敏度为90.48%,特异度为56.67%。结论静息心电图检查对CHD诊断具有一定的临床价值,尤其是对于多支病变、狭窄程度较重的患者具有更高的诊断灵敏度。

OBJECTIVE To investigate the clinical value of resting electrocardiogram in the differential diagnosis of coronary heart dis-ease（CHD） patients. METHODS A total of 247 patients with CHD were enrolled in this study. All subjects were treated with restingelectrocardiogram and coronary angiography. The results of coronary angiography were used as diagnostic gold standard,respectively,to calculate the number of different coronary artery lesions, different coronary artery stenosis in patients with CHD using resting elec-trocardiogram diagnosis of clinical value. RESULTS 247 patients with high suspicion, coronary angiography confirmed 187 patientswith CHD and 60 patients with non-CHD. According to Table 1, the sensitivity of CHD was 72.19%, the specificity was 56.67%, themissed rate was 27.81% Misdiagnosis rate was 43.33%, positive predictive value was 83.85%, negative predictive value was 39.53%;electrocardiogram diagnosis CHD single disease patients with sensitivity of 51.92%, specificity of 56.67%; electrocardiogram diagnosisof CHD patients with double sensitivity of 74.07 %. The specificity of 56.67% ECG diagnosis of CHD three patients with a sensitivityof 87.04%, specificity of 56.67%; ECG diagnosis of CHD mild stenosis patients with a sensitivity of 42.65%, specificity of 56.67%;ECG diagnosis of moderate CHD The sensitivity of the patients was 74.03% and the specificity was 56.67%. The sensitivity of theelectrocardiogram was 90.48% and the specificity was 56.67%. CONCLUSION Resting electrocardiogram had a certain clinical valuein the diagnosis of CHD, especially for patients with multiple lesions, severe stenosis of patients with a higher diagnostic sensitivity.