SAAHECG对冠心病的诊断价值及与冠状动脉狭窄程度的关系探讨

Value of saah electrocardiography for diagnosing coronary heart disease and its relationship with coronary arterial stenosis degree

目的探讨尼沙赫心电图(SAAHECG)在冠心病诊断中的应用及其与不同冠状动脉狭窄程度的关系。方法回顾性分析2016年10月至2020年12月有胸闷、胸痛的临床症状且在该院施行冠状动脉造影术(CAG)的患者209例,所有患者术前均同步行SAAHECG及常规心电图(ECG)检查。根据冠状动脉造影结果,分为非冠心病组即对照组(冠状动脉狭窄<50%),冠心病组(冠状动脉狭窄≥50%)。将冠心病组分为轻度狭窄组(冠状动脉狭窄50%~69%)、中度狭窄组(冠状动脉狭窄70%~89%)和重度狭窄组(冠状动脉狭窄≥90%)3组。观察SAAHECG与ECG对冠心病诊断的灵敏度、特异性,以及SAAHECG与ECG在冠状动脉不同狭窄程度时的灵敏度。结果SAAHECG与ECG诊断冠心病的灵敏度分别为82.56%、49.42%,差异有统计学意义(P<0.05),特异性分别为48.65%、43.24%,差异无统计学意义(P>0.05)。从轻度狭窄组到重度狭窄组SAAHECG与ECG的诊断灵敏度依次为:63.16%/26.32%、74.51%/43.14%、90.20%/56.86%,其中,SAAHECG在重度狭窄组灵敏度最高,与轻度狭窄组、中度狭窄组比较,差异均有统计学意义(P<0.0167)。ECG在重度狭窄组的灵敏度显著高于轻度狭窄组(P<0.0167),与中度狭窄组比较,差异无统计学意义(P>0.0167)。结论SAAHECG S-T间期新小波对心肌缺血导致的电活动有很高的敏感性,对冠心病的诊断特别是对严重冠状动脉病变的患者有重要的临床应用价值。

Objective To investigate the application of saah electrocardiography(SAAHECG)in diagnosing coronary heart disease(CHD)and its relationship with the stenosis degrees of different coronary arteries.Methods A total of 209 patients with chest distress and chest pain conducting coronary angiography(CAG)in this hospital from October 2016 to December 2020 were retrospectively analyzed.The patients were divided into the non-CHD group(control group,coronary stenosis<50%)and CHD group(coronary stenosis≥50%)according to the CAG results.The CHD group was divided into the mild stenosis group(coronary arterial stenosis 50%-69%),middle stenosis group(coronary arterial stenosis 70%-89%)and severe stenosis group(coronary arterial stenosis≥90%).The sensitivity and specificity of saahECG and ECG for diagnosing CHD were observed.The sensitivity of SAAHECG and ECG in different stenosis of coronarial arteries was observed.Results The sensitivities of SAAHECG was significantly higher than that of ECG,and the difference was statistically significant(82.56%vs.49.42%,P<0.05).The specificity were 48.65%and 43.24%,and the difference was statistically significant(P>0.05).The sensitivities of SAAHECG from the mild stenosis group to severe stenosis group were in turn 63.16%/26.32%,74.51%/43.14%and 90.20%/56.86%respectively,the sensitivity of ECG was the highest in the severe stenosis group,the difference was statistically significant compared with the mild stenosis group and moderate stenosis group(P<0.0167).The sensitivity of ECG in the severe stenosisi group was significantly higher than that in the mild stenosis group(P<0.0167),there was no statistically significant difference compared with the moderate stenosis group(P>0.0167).Conclusion The new wavelet of S-T interval of SAAHECG has very high sensitivity to the electrical activity caused by myocardial ischemia,SAAHECG is superior to the conventional ECG in the diagnosis of CHD.Under the circumstance of without reducing its specificity,it can significantly improve the sensitivity,moreover its sensitivty is the highest when the degree of coronary artery stenosis exceeds 90%,and has the important clinical application value for the diagnosis of CHD,especially for the patients with severe coronary arterial lesion.