心电图指标对冠心病的定性及定量诊断──与SPECT心肌显像的相关分析

QUALITATIVE AND QUANTITATIVE DIAGNOSIS OF CORONARY ARTERY DISEASE USING INDEXES OF ELECTROCARDIOGRAPHY-CORRELATIVE ANALYSIS OF SPECT MYOCARDIAL PERFUSION IMAGING

为进一步探讨心电图运动试验对冠心病的诊断价值，观察30例冠心病及28名对照者运动试验中ST及非ST参数的变化，并与心肌灌注断层显像进行相关分析，结果表明：①△Q－Tc及△Q诊断冠心病的敏感性较高（83．3％及76．7％）；特异性以U波倒置及∑R指标较高（100％及89．3％）；②ST段压低及U波倒置对前壁、间壁、侧壁的阳性检出率高于下后壁，其它指标无显著性差异；③ST段压低程度以及R波振幅变化（△R、△RST、∑R）可反映心肌缺血的范围和（或）心肌供血减少的程度；④△Q、△Q-Tc、△J-Tc无定量分析意义；⑤U波例置见于大范围心肌缺血患者，同时也是良好侧支循环建立的标志。

In order to judge the value of diagnosis of coronary artery disease(CAD)using exercise electrocardiography, the change of ST and non-ST parameters in exercise electrocardiography, was observed the correlation between the parameters and myocardial perfusion imaging analysed. Two groups of subjects were used:one consisting of 28 normal subjects as the control, and the other of 30 patients with CAD This study demonstrates that: 1. △Q-Tc and △Q are very sensitive idexes for diagnosing CAD the sensitivety being 83.3% and 76. 7 % respetive; U wave invertion and ∑R are more specific indexes (100% and 89. 3%) ; 2. S-T segments depression and U wave inversion are idexes of myocardial ischemia the rate of detecting myocardial ischemia in the anterior,lateral and septal walls is higher than in the posterior and inferior walls other idexes show no significant difference. 3.The degree of S-T depression and the change of R wave can reflex the size and degree of myocardial ischimia: 4. △Q. △Q-T and △J-Tc do not have any significance in quantitative analysis ; 5. U-wave inversion is not only reflexes myocardial ischimia of larde size,but is also the sign of the eatablishment of collateral circulation.