本文選題：心電圖 + CT冠狀動脈造影��； 參考：《青島大學》2013年碩士論文

【摘要】：目的了解疑診冠心病(Coronary artery heart disease CHD)患者的常規(guī)十二導聯(lián)心電圖(electrocardiogram ECG)不同ST-T改變與CT冠狀動脈造影(CTcoronary angiography,CTA)病變特征之間的聯(lián)系。 方法選取疑診冠心病的82例患者為研究對象,按心電圖ST-T改變的結(jié)果分為陽性組、陰性組,比較兩組間冠狀動脈狹窄情況及冠狀動脈CT斑塊病變特征。所有的數(shù)據(jù)用SPSS17.0統(tǒng)計軟件處理。統(tǒng)計學方法計數(shù)資料采用x2檢驗,秩和檢驗,P0.05為差異有統(tǒng)計學意義。 結(jié)果1.ECG與CTA在診斷冠心病的結(jié)果方面的比較：兩組比較差異無統(tǒng)計學意義(P0.05)。82例疑診冠心病患者中CTA陽性48例,占58.53%,其中ECG陽性31例,占37.80%；CTA陰性34例,占41.46%。其中ECG陰性17例,占20.73%。ECG的靈敏度：64.53%特異度：50%,假陽性率：50%假陰性率：35.42%,陽性預測值：64.58%,陰性預測值：50%,kappa值：0.146。 2.ECG不同結(jié)果冠脈狹窄程度比較：兩組比較差異無統(tǒng)計學意義(P0.05)。ECG陽性組共檢出狹窄50%冠脈10支,狹窄50%-74%冠脈16支,≥75%冠脈47支,共73支狹窄冠脈。ECG陰性組共檢出狹窄50%冠脈18支,狹窄50%-74%冠脈11支,≥75%冠脈10支,共39支狹窄冠脈。ECG陽性組患者冠脈的中重度狹窄比例明顯多于陰性組(47/10)。 3.ECG不同結(jié)果冠脈病變血管支數(shù)比較：兩組比較差異無統(tǒng)計學意義(P0.05)。ECG陽性組48例患者,其中CTA正常者17例,單支病變6例,雙支病變10例,多支病變15例。ECG陰性組34例患者,其中CTA陽性有17例,其中單支病變11例,雙支病變4例,多支病變2例。ECG陰性組患者單支病變數(shù)目多于陽性組(11/6)。ECG陽性組雙支和多支病變比例多于陰性組(10/4,15/2)。 4.ECG不同結(jié)果冠脈斑塊特征比較：兩組比較差異無統(tǒng)計學意義(P0.05)。ECG陽性組檢出鈣化斑塊94塊,非鈣化斑塊36塊,共130塊。ECG陰性組檢出鈣化斑塊42塊,非鈣化斑塊23塊,共65塊。ECG陽性組患者冠脈斑塊的比例明顯多于陰性組(130/65)。 結(jié)論ECG不同ST-T改變對冠脈狹窄程度,病變支數(shù)及冠脈斑塊特征的預測價值不大,對ECG不同ST-T改變陰性或者陽性患者,不應輕易否定或確定冠心病診斷,而應結(jié)合臨床情況進行綜合分析。
[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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