医学论文：浅谈心电图st-t改变对诊断冠心病的价值.docVIP

浅谈摘要 目的 探讨心电图st-t改变诊断冠心病的可靠性。? 方法 对206例有st-t改变的患者行18导联心电图、动态心电图、冠脉造影检查，并对st-t改变与造影结果对比分析。? 结果 67例st-t改变有动态变化的患者确诊冠心病例数为46例，符合率68.7%,而139例st-t改变始终无动态变化的患者确诊冠心病例数为47例，符合率33.8%。? 结论? st-t改变无动态变化诊断冠心病可靠性小，应尽早行冠脉造影明确诊断；st-t改变有动态变化诊断冠心病可靠性大，对临床诊断有指导意义。 关键词? 心电图;?? st-t改变;?? 动态心电图;?? 冠脉造影;?? 冠心病 abstract? objective? to study reliability of electrocardiogram st-t change in diagnosing coronary atherosclerotic heart disease . methods? two hundred six patients were checked by electrocardiogram,24 hours dynamic electrocardiogram and coronary angiography.the relationship between electrocardiogram st-t change and coronary angiography results was analysed. results?? 67 cases was confirmed of developing electrocardiogram st-t change, in it, 46 cases was diagnosed? coronary atherosclerotic heart disease,coincidence rate 68.7%. in 139 cases without developing electrocardiogram st-t change,47 cases was diagnosed coronary atherosclerotic heart disease, conincidence rate 33.8%.? conclusion?? without developing electrocardiogram st-t change, the reliability of diagnosing coronary atherosclerotic heart　disease is little, we should perform coronary angiography as early as possible. however, developing electrocardiogram st-t change is helpful to diagnose? coronary atherosclerotic heart　disease. key words electrocardiogram；? st-t change；? dynamic electrocardiogram；? coronary angiography；? coronary atherosclerotic heart disease ????? 心电图的st-t改变,即st段水平型或下斜型压低≥0.05mv，可伴或不伴有t波低平、倒置，是冠心病的标志性变化。那么，心电图有st-t改变就一定存在冠状动脉粥? 硬化伴管腔狭窄吗？随着冠脉介入治疗的发展，冠脉造影（cag）已成为诊断冠心病的金标准，心电图st-t改变诊 断冠心病的可靠性受到质疑。本文对206例心电图有st-t改变的患者行冠脉造影，并对结果进行分析，从而探讨st-t改变对诊断冠心病的价值。 1资料与方法 1．1对象：选择2007年1月到2008年3月我院住院病人中心电图有st-t改变，初步诊为冠心病的患者206例，进行18导联心电图、12导联同步全息动态心电图、冠脉造影检查。其中男性124例，女性82例，年龄43~84岁（54.3±14.2）岁。根据是否存在动态st-t改变分成两组。a组（67例）：胸闷、胸痛等心绞痛症状发作时或24小时动态心电图检查示st-t有动态变化st段压低更明显或t波更加低平、倒置（变化≥1mm,持续时间至少1分钟），或st-t假性正常化；b组（139例）：有或无心绞痛症状，心绞痛症状发作时或24小时动态心电图检查示st-t始终无动态变化。 1．2方法：入院当天、次日、第3天各描记一次18导联心电图（标准12导联加v7~9,v3r~5r）；如有心绞痛症状发作，则在发作