中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
19期
2910-2912,2913
,共4页
于倩%李丽%左秀英%张军
于倩%李麗%左秀英%張軍
우천%리려%좌수영%장군
心绞痛%心肌缺血%心电描记术%超声心动描记术,压力
心絞痛%心肌缺血%心電描記術%超聲心動描記術,壓力
심교통%심기결혈%심전묘기술%초성심동묘기술,압력
Angina pectoris%Myocardial ischemia%Electrocardiography%Echocardiography%Stress
目的：通过研究缺血性心脏病、不稳定型心绞痛患者心电图及超声心动图的异常改变，对比冠状动脉造影结果，旨在对冠状动脉三支病变再认识。方法选取缺血性心脏病、不稳定型心绞痛行冠状动脉造影患者2654例，将冠状动脉造影所获得的结果与心电图、超声心动图表现进行统计分析。结果（1）心电图、超声心动图的异常改变对冠状动脉三支病变有一定的预测价值，差异均有统计学意义（χ2＝9．02、14．36，均 P ＜0．01）。心电图对冠状动脉三支病变的敏感性为71．46％，特异性为27．47％，假阳性率为62．26％，假阴性率为28．50％；超声心动图对冠状动脉三支病变的敏感性为61．27％，特异性为27．08％，假阳性率为72．91％，假阴性率为38．72％。（2）冠状动脉三支病变患者心绞痛发作时，心电图检查改变多出现在8个以上导联，心电图胸前导联终末正向 T 波发生率均高于90％，Ⅲ导联心电图 fQRS 波群或低电压改变，约占心绞痛发作时心电图的82．61％，AVR 导联 ST 段抬高约占发作心电图的56．52％。结论心电图及超声心动图的异常改变在一定程度上能预测冠状动脉三支病变；冠状动脉三支病变患者心绞痛急性发作期心电图有特征性波形改变。
目的：通過研究缺血性心髒病、不穩定型心絞痛患者心電圖及超聲心動圖的異常改變，對比冠狀動脈造影結果，旨在對冠狀動脈三支病變再認識。方法選取缺血性心髒病、不穩定型心絞痛行冠狀動脈造影患者2654例，將冠狀動脈造影所穫得的結果與心電圖、超聲心動圖錶現進行統計分析。結果（1）心電圖、超聲心動圖的異常改變對冠狀動脈三支病變有一定的預測價值，差異均有統計學意義（χ2＝9．02、14．36，均 P ＜0．01）。心電圖對冠狀動脈三支病變的敏感性為71．46％，特異性為27．47％，假暘性率為62．26％，假陰性率為28．50％；超聲心動圖對冠狀動脈三支病變的敏感性為61．27％，特異性為27．08％，假暘性率為72．91％，假陰性率為38．72％。（2）冠狀動脈三支病變患者心絞痛髮作時，心電圖檢查改變多齣現在8箇以上導聯，心電圖胸前導聯終末正嚮 T 波髮生率均高于90％，Ⅲ導聯心電圖 fQRS 波群或低電壓改變，約佔心絞痛髮作時心電圖的82．61％，AVR 導聯 ST 段抬高約佔髮作心電圖的56．52％。結論心電圖及超聲心動圖的異常改變在一定程度上能預測冠狀動脈三支病變；冠狀動脈三支病變患者心絞痛急性髮作期心電圖有特徵性波形改變。
목적：통과연구결혈성심장병、불은정형심교통환자심전도급초성심동도적이상개변，대비관상동맥조영결과，지재대관상동맥삼지병변재인식。방법선취결혈성심장병、불은정형심교통행관상동맥조영환자2654례，장관상동맥조영소획득적결과여심전도、초성심동도표현진행통계분석。결과（1）심전도、초성심동도적이상개변대관상동맥삼지병변유일정적예측개치，차이균유통계학의의（χ2＝9．02、14．36，균 P ＜0．01）。심전도대관상동맥삼지병변적민감성위71．46％，특이성위27．47％，가양성솔위62．26％，가음성솔위28．50％；초성심동도대관상동맥삼지병변적민감성위61．27％，특이성위27．08％，가양성솔위72．91％，가음성솔위38．72％。（2）관상동맥삼지병변환자심교통발작시，심전도검사개변다출현재8개이상도련，심전도흉전도련종말정향 T 파발생솔균고우90％，Ⅲ도련심전도 fQRS 파군혹저전압개변，약점심교통발작시심전도적82．61％，AVR 도련 ST 단태고약점발작심전도적56．52％。결론심전도급초성심동도적이상개변재일정정도상능예측관상동맥삼지병변；관상동맥삼지병변환자심교통급성발작기심전도유특정성파형개변。
Objective To further recognize the coronary artery three vessel disease by studying the abnormal change of the electrocardiogram(ECG)and echocardiography of ischemic heart disease patients and unstable angina pectoris patients,and to analyze the results of coronary angiography.Methods Coronary arteriography for 2 654 patients diagnosed as ischemic heart disease,unstable angina pectoris,were conducted and the result of coronary arteriography were compared with the ECG and echocardiography.Results There were certain statistically significant correlation among the ECG,echocardiography abnormal change and three vessel coronary artery disease(ECG:χ2 =9.02,P <0.01;echocardiography:χ2 =14.36,P <0.01).The sensitivity,specificity,false positive rate,and false negative rate of ECG were 71.46%,27.47%,62.26% and 28.50% respectively.The sensitivity,specificity,false positive rate, and false negative rate of echocardiography were 61.27%,27.08%,72.91% and 38.72% respectively.ECG′s change of patients appear in 8 or more leads when angina pectoris attacks exist,the incidence of chest lead terminal positive T wave were higher than 90.00%.Ⅲ lead fQRS wave group or low voltage changeed and AVR lead ST seg-ment elevation were accounting for 82.61% and 56.52% respectively.Conclusion There are certain correlation and predictive value among the ECG,echocardiography and three vessel coronary artery disease.There are characteristic waveform change of ECG when angina pectoris attacks exist.
