不同心电图检测诊断老年冠心病的价值比较

发布时间：2018-06-07 05:39

本文选题：冠状动脉造影 + 常规心电图　；参考：《中国老年学杂志》2017年20期

【摘要】：目的探讨以冠状动脉造影(CAG)作为诊断冠心病标准的常规心电图、动态心电图及平板运动试验(TET)对诊断老年冠心病的临床价值。方法选取接受检查疑似老年冠心病患者110例,间隔2 w内患者均先后行常规心电图、TET、动态心电图、CAQG检查。以CAG检查结果为标准,比较三种检查方法的冠心病检出率,敏感性、特异性、精准性等指标。结果 110例患者经CAG检查诊断出阳性患者82例,其中轻度狭窄28例,中度狭窄42例,严重狭窄12例;单支病变30例,多支病变52例;冠心病阳性检出率比较,TET动态心电图,均显著高于常规心电图(均P0.05),TET及动态心电图检查的轻度狭窄、严重狭窄多支病变检出率均显著高于常规心电图检查(均P0.05),且两组间差异不明显(P0.05);中度狭窄及单支病变检出率,三组间差异不显著(均P0.05)。此外,三组检查方法多支病变的检出率显著高于组内单支病变(均P0.05);敏感性及准确性比较,常规心电图动态心电图TET,且敏感性比较差异有统计学意义(均P0.05),准确性比较差异不显著(均P0.05),特异性常规心电图动态心电图TET,差异有统计学意义(均P0.05)。结论三种检查方法在老年冠心病的诊断中均各具其临床价值,为尽可能提高疾病的诊断率,必要时可采用多种检查方法联合进行诊断。
[Abstract]:Objective to investigate the clinical value of routine electrocardiogram (ECG), dynamic electrocardiogram (ECG) and treadmill exercise test (TTE) in the diagnosis of coronary heart disease (CHD). Methods 110 patients with suspected elderly coronary heart disease were examined. The patients were examined by routine ECG and dynamic electrocardiogram (ECG) and CAQG respectively within 2 weeks. The detection rate, sensitivity, specificity and accuracy of coronary heart disease (CHD) were compared with the results of CAG. Results 82 cases were diagnosed by CAG, including 28 cases of mild stenosis, 42 cases of moderate stenosis, 12 cases of severe stenosis, 30 cases of single vessel disease and 52 cases of multi-vessel disease. The positive rate of coronary heart disease was compared with that of Tet dynamic electrocardiogram. The detection rate of multivessel lesions in severe stenosis was significantly higher than that in routine electrocardiogram (P0.05T and dynamic electrocardiogram examination). There was no significant difference among the three groups (all P 0.05). In addition, the detection rate of multivessel lesions in the three groups was significantly higher than that in the single vessel lesions of the three groups (all P 0.05). There was significant difference in sensitivity and accuracy (all P0.05%, P 0.05), and the difference was statistically significant (all P0.05%, P0.05%, P 0.05), and the difference was statistically significant (all P0.05%, P 0.05%), and the difference was statistically significant (all P0.05%, P 0.05), and the difference was statistically significant (P 0.05). Conclusion all the three methods have their clinical value in the diagnosis of coronary heart disease in the elderly. In order to improve the diagnosis rate of disease as much as possible, a variety of examination methods can be used to diagnose the disease.
【作者单位】：金华市人民医院;浙江大学医学院附属第一医院心血管内科;
【分类号】：R540.41;R541.4

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