摘要
目的探讨动态心电图QTc间期对可疑冠状动脉粥样硬化性心脏病(冠心病)患者心肌缺血的诊断和预测价值。方法选择2011年6月至2012年6月在北京市顺义区中医医院诊治的有症状或存在冠心病危险因素的可疑冠心病患者88例为研究对象,监测12导联动态心电图,并行冠状动脉造影,根据冠状动脉造影结果分为阳性组(56例)和阴性组(32例)。测量比较两组QTc间期等心电图指标的改变。结果冠状动脉造影阳性组患者男性比例、年龄、糖尿病比例高于阴性组(P<0.05)。冠状动脉造影阳性组和阴性组在ST段严重压低时各心电图指标中QT和QTc间期比较差异有统计学意义,阳性组显著长于阴性组(P<0.05)。结论在冠心病心肌缺血发作时,动态心电图上除ST段发生特征性变化外,QTc也会发生延长等相应的变化,联合ST段和QTc变化进行诊断,能够提高诊断的特异性和阳性预测值。
Objective To discuss clinical significance of dynamic electrocardiogram QTc in diagnosis and prognosis of myocardial ischemia of suspected coronary heart disease（ CHD）. Methods A total of 88 suspected CHD cases with symptoms or the presence of CHD risk factors in Beijing Shunyi District TCM Hospital,from Jun. 2011 to Jun. 2012 were included in the study,and their 12 lead dynamic ECG were monitored,and coronary arteriography was done on all of the subjects. According to results of coronary arteriography,they were divided into positive group and negative group. QTc and other ECG index were compared between the two groups. Results Male proportion,age and diabetes mellitus proportion of the positive group were higher than the negative group（ P 0. 05）. QT and QTc of the positive group were significantly longer than the negative group when ST segment was seriously depressed（ P 0. 05）. Conclusion ECG of patients with acute myocardial ischemia shows QTc prolongation besides ST depression. Combined ST and QTc can improve specificity and positive predictive value in diagnosis of myocardial ischemia.
出处
《医学综述》
2015年第2期317-319,326,共4页
Medical Recapitulate
关键词
冠心病
动态心电图
心肌缺血
Coronary heart disease
Dynamic electrocardiogram
Myocardial ischemia
