心电图ST-T改变与冠脉CT病变特征的对比分析

发布时间：2018-04-20 20:27

  本文选题：心电图 + CT冠状动脉造影　； 参考：《青岛大学》2013年硕士论文

【摘要】：目的了解疑诊冠心病(Coronary artery heart disease CHD)患者的常规十二导联心电图(electrocardiogram ECG)不同ST-T改变与CT冠状动脉造影(CTcoronary angiography,CTA)病变特征之间的联系。 方法选取疑诊冠心病的82例患者为研究对象,按心电图ST-T改变的结果分为阳性组、阴性组,比较两组间冠状动脉狭窄情况及冠状动脉CT斑块病变特征。所有的数据用SPSS17.0统计软件处理。统计学方法计数资料采用x2检验,秩和检验,P0.05为差异有统计学意义。 结果1.ECG与CTA在诊断冠心病的结果方面的比较：两组比较差异无统计学意义(P0.05)。82例疑诊冠心病患者中CTA阳性48例,占58.53%,其中ECG阳性31例,占37.80%；CTA阴性34例,占41.46%。其中ECG阴性17例,占20.73%。ECG的灵敏度：64.53%特异度：50%,假阳性率：50%假阴性率：35.42%,阳性预测值：64.58%,阴性预测值：50%,kappa值：0.146。 2.ECG不同结果冠脉狭窄程度比较：两组比较差异无统计学意义(P0.05)。ECG阳性组共检出狭窄50%冠脉10支,狭窄50%-74%冠脉16支,≥75%冠脉47支,共73支狭窄冠脉。ECG阴性组共检出狭窄50%冠脉18支,狭窄50%-74%冠脉11支,≥75%冠脉10支,共39支狭窄冠脉。ECG阳性组患者冠脉的中重度狭窄比例明显多于阴性组(47/10)。 3.ECG不同结果冠脉病变血管支数比较：两组比较差异无统计学意义(P0.05)。ECG阳性组48例患者,其中CTA正常者17例,单支病变6例,双支病变10例,多支病变15例。ECG阴性组34例患者,其中CTA阳性有17例,其中单支病变11例,双支病变4例,多支病变2例。ECG阴性组患者单支病变数目多于阳性组(11/6)。ECG阳性组双支和多支病变比例多于阴性组(10/4,15/2)。 4.ECG不同结果冠脉斑块特征比较：两组比较差异无统计学意义(P0.05)。ECG阳性组检出钙化斑块94块,非钙化斑块36块,共130块。ECG阴性组检出钙化斑块42块,非钙化斑块23块,共65块。ECG阳性组患者冠脉斑块的比例明显多于阴性组(130/65)。 结论ECG不同ST-T改变对冠脉狭窄程度,病变支数及冠脉斑块特征的预测价值不大,对ECG不同ST-T改变阴性或者阳性患者,不应轻易否定或确定冠心病诊断,而应结合临床情况进行综合分析。
[Abstract]:Objective to investigate the relationship between the changes of conventional 12-lead electrocardiogram (ST-T) in patients with coronary artery heart disease (CAD) and the characteristics of CT coronary angiographyography (CTCA) in patients with suspected coronary artery disease (CHD). Methods Eighty-two patients with suspected coronary heart disease were divided into positive group and negative group according to the results of ECG ST-T changes. Coronary artery stenosis and coronary artery CT plaque lesion were compared between the two groups. All data are processed with SPSS17.0 statistical software. Statistical method count data using x2 test, rank sum test P 0.05 for the difference was statistically significant. Results the comparison between 1.ECG and CTA in the diagnosis of coronary heart disease: there was no significant difference between the two groups in the diagnosis of coronary heart disease. There were 48 cases (58.53%) with positive CTA in 82 patients with suspected coronary heart disease. Among them, 31 cases were positive for ECG, 34 cases were negative for ECG and 37.80% were negative for CTA, accounting for 41.46%. Among them, 17 cases were negative for ECG, accounting for the sensitivity of 20.73%.ECG: 64.53%, specificity: 50%, false positive rate: 50%, false negative rate: 35.42, positive predictive value: 64.58, negative predictive value: 50%, Kappa: 0.146. Comparison of coronary stenosis degree in different 2.ECG results: there was no significant difference between the two groups. In the ECG positive group, there were 10 stenoses of 50% coronary arteries, 16 stenoses of 50 -74% coronary arteries, and 47 coronary arteries 鈮，

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