[1]文翠,赵新军,张震洪,等.冠心病患者心电图ST段改变与多排螺旋CT冠状动脉成像的关系分析[J].中国医学物理学杂志,2020,37(8):1035-1039.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.018]
　WEN Cui,ZHAO Xinjun,ZHANG Zhenhong,et al.Relationships between ECG ST-segment changes and multi-slice spiral CT coronary angiography in patients with coronary heart disease[J].Chinese Journal of Medical Physics,2020,37(8):1035-1039.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.018]
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冠心病患者心电图ST段改变与多排螺旋CT冠状动脉成像的关系分析()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第8期
页码:
1035-1039
栏目:
医学影像物理
出版日期:
2020-08-27

文章信息/Info

Title:
Relationships between ECG ST-segment changes and multi-slice spiral CT coronary angiography in patients with coronary heart disease
文章编号:
1005-202X（2020）08-1035-05
作者:
文翠1; 赵新军2; 张震洪3; 袁健祥4; 王文会5
1.佛山市中医院功能检查科， 广东 佛山 528000； 2.广州中医药大学第一附属医院心血管内科， 广东 广州 510000； 3.佛山市第二人民医院心血管内科， 广东 佛山 528000； 4.佛山市中医院CT室， 广东 佛山 528000； 5.佛山市中医院心血管内科， 广东 佛山 528000
Author(s):
WEN Cui1;  ZHAO Xinjun2;  ZHANG Zhenhong3;  YUAN Jianxiang4;  WANG Wenhui5
1. Department of Functional Examination, Foshan Hospital of TCM, Foshan 528000, China 2. Department of Cardiovascular Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, China 3. Department of Cardiovascular Medicine, the Second Peoples Hospital of Foshan City, Foshan 528000, China 4. CT Room, Foshan Hospital of TCM, Foshan 528000, China 5. Department of Cardiovascular Medicine, Foshan Hospital of TCM, Foshan 528000, China
关键词:
冠心病; 心电图; 多排螺旋CT; 冠状动脉成像
Keywords:
Keywords: coronary heart disease electrocardiogram multi-slice spiral CT coronary angiography
分类号:
R541.1
DOI:
DOI:10.3969/j.issn.1005-202X.2020.08.018
文献标志码:
A
摘要:
目的：通过对心电图ST段改变及多排螺旋CT冠状动脉成像（MSCTCA）检查在冠心病诊断中的比较分析，探讨冠心病诊断中心电图和MSCTCA检查的方法和作用，为临床诊断提供更多有效的信息。方法：选取临床诊断疑似或确诊为冠心病患者64例，进行心电图和MSCTCA检查，比较两种方法的一致性，不同部位、不同程度及不同类型病变检查的阳性率。结果：与MSCTCA方法相比，心电图ST段改变检查的灵敏度为56.82%，特异度为50%，总体符合率为54.69%，Kappa值为0.061，两种方法检查一致性较差，差异具有显著性（P<0.05）；I/avL/V1-5导联ST段改变阳性患者与Ⅱ/Ⅲ/avF导联ST段改变阳性患者相比，以MSCTCA检查的阳性率更高（P<0.05）；冠状动脉重度狭窄患者与轻度患者相比，心电图ST段改变阳性率显著升高（P<0.05）；中度狭窄患者与轻度患者相比，心电图ST段改变阳性率差异不显著（P>0.05）；多支冠状动脉病变患者心电图ST段改变阳性率显著高于单支管状动脉病变患者（P<0.05）。结论：心电图与MSCTCA检查一致性较差，临床上不宜单独使用单一检查方法；在重度冠状动脉狭窄患者及多支冠状动脉病变患者中，心电图ST段改变检出率较高，结果具有参考价值；I/avL/V1-5导联ST段改变阳性患者相比Ⅱ/Ⅲ/avF导联ST段改变阳性患者，MSCTCA检查阳性率更高，更具有检测意义。
Abstract:
Abstract: Objective To explore the methods and roles of electrocardiogram (ECG) and multi-slice spiral CT coronary angiography (MSCTCA) in the diagnosis of coronary heart disease (CHD) by comparing and analyzing ECG ST-segment changes and MSCTCA, thereby providing more effective information for the clinical diagnosis of CHD. Methods A total of 64 patients with suspected or confirmed CHD by clinical diagnosis underwent ECG and MSCTCA. The examination consistency between two methods was compared, and the positive rates of two methods in the examination of lesions of different parts, different degrees and different types were also compared. Results Compared with MMSCCA, ECG ST-segment changes had a sensitivity, specificity and overall coincidence rate of 56.82%, 50% and 54.69%, respectively. The test consistency between two methods was poor (Kappa=0.061, P<0.05). The positive rate of MSCTCA in patients with positive I/avL/V1-5 lead ST-segment changes and those with positive II/III/avF lead ST-segment changes was significantly higher (P<0.05), while the positive rate of ECG ST-segment changes in patients with severe and mild coronary artery stenosis was significantly increased (P<0.05). The positive rate of ECG ST-segment changes in patients with moderate coronary stenosis was similar to that in patients with mild coronary stenosis (P>0.05), but the positive rate of ECG-ST segment changes in patients with multiple-vessel coronary artery lesions was significantly higher than that in patients with single-vessel coronary artery lesions (P<0.05). Conclusion The consistency between ECG and MSCTCA is poor. In clinic, it is not appropriate to adopt ECG or MSCTCA alone. ECG ST segment changes have higher detection rates in patients with severe coronary artery stenosis and those with multiple-vessel coronary artery lesions, while MMSCCA has higher detection rates in patients with postitive I/avL/V1-5 lead ST-segment changes and those with positive II/III/avF leads ST-segment changes.

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备注/Memo

备注/Memo:
【收稿日期】2020-03-11 【基金项目】广东省医学科研基金（A2017550） 【作者简介】文翠，研究方向：冠心病诊断，E-mail: 63817679@qq.com
更新日期/Last Update: 2020-08-27