心電圖與冠狀動脈造影診斷冠心病的價值分析

陳珊

摘 ? 要：目的 ?探討心電圖檢查與冠狀動脈造影檢查在冠心病患者中的診斷價值。方法 ?選取2016年10月～2018年10月于九江市柴桑區人民醫院住院的疑似冠心病患者110例，所有患者行常規心電圖和冠狀動脈造影檢查，比較心電圖檢查結果和冠狀動脈造影結果。結果 ?①ST-T改變在心電圖中診斷率為65.45%，高于冠狀動脈造影檢查的60.91%，二者比較，差異無統計學意義（P>0.05）;②冠狀動脈造影檢查確診冠心病患者67例。其中ST-T改變診斷率為58.21%，高于非ST-T改變的41.79%，ST-T改變在確診冠心病方面優于非ST-T改變，差異具有統計學意義（P<0.05）。結論 ?冠狀動脈造影檢查仍是臨床確診冠心病的首選方法，心電圖ST-T改變能夠為早期冠心病診斷方面提供依據，臨床確診還需結合冠狀動脈造影等相關檢查。

關鍵詞：冠狀動脈造影;冠心病;ST-T改變;心電圖

中圖分類號：R541.4 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2018.24.036

文章編號：1006-1959（2018）24-0126-02

Abstract：Objective ?To investigate the diagnostic value of electrocardiogram and coronary angiography in patients with coronary heart disease.Methods ?A total of 110 patients with suspected coronary heart disease who were admitted to the People's Hospital of Chaisang District， Jiujiang City from October 2016 to October 2018 were enrolled. All patients underwent routine electrocardiogram and coronary angiography， and the results of ECG and coronary angiography were compared.Results ?①The diagnostic rate of ST-T changes in electrocardiogram was 65.45%， which was higher than 60.91% in coronary angiography. There was no significant difference between the two （P>0.05）. ②Coronary angiography confirmed 67 patients with coronary heart disease. Among them， the diagnosis rate of ST-T change was 58.21%，Compared with non-ST-T changes of 41.79%， ST-T changes were superior to non-ST-T changes in the diagnosis of coronary heart disease，the difference was statistically significant （P<0.05）.Conclusion ?Coronary angiography is still the first choice for clinical diagnosis of coronary heart disease. ECG ST-T changes can provide a basis for the diagnosis of early coronary heart disease. Clinical diagnosis is also required to be combined with coronary angiography.

Key words：Coronary angiography;Coronary heart disease;ST-T change;Electrocardiogram

冠狀動脈粥樣硬化性心臟病（coronary atherosclerotic heart disease，CHD）是冠狀動脈血管發生動脈粥樣硬化病變而引起血管腔狹窄或阻塞，造成心肌缺血、缺氧或壞死而導致的心臟病，通常稱為“冠心病”[1]。臨床可表現為心絞痛、心律失常、心肌梗死等，甚至發生猝死，嚴重危及患者生命安全。目前臨床常采用藥物和冠狀動脈介入治療，部分危重患者采用心肌橋切除手術或冠狀動脈搭橋治療[2，3]。冠心病患者早期心電圖可有ST-T改變或者正常。冠脈造影是經動脈插管直接注射造影劑再經X光拍片得出心臟冠狀動脈圖像，是目前臨床確診冠心病最常用和最準確的方法。研究顯示，冠心病患者的遠期預后與早期診斷密切相關[4]。因此早期診斷顯得尤為重要，亦是臨床醫生診治冠心病的重點。為研究冠狀動脈造影檢查在冠心病診斷中的應用價值，本研究選擇我院收治的110例疑似冠心病患者進行研究，現報道如下。