摘要
目的:探讨静息心电图Ⅱ、Ⅲ及a VF导联病理性Q波诊断冠状动脉多支血管病变的临床价值。方法:回顾性分析收治的527例心肌梗死患者的临床病历资料,并按照梗死部位将分为前壁心肌梗死和下壁心肌梗死,以冠状动脉造影结果为"金标准",比较病理性Q波对不同梗死部位冠状动脉多支血管病变的诊断价值。结果:心肌梗死患者的冠状动脉造影结果提示前壁心肌梗死患者304例(57.69%),下壁心肌梗死患者223例(42.31%);361例(68.50%)患者为冠状动脉多支血管病变,其中前壁心肌梗死患者236例,下壁心肌梗死患者125例,166例(31.50%)为非多支血管病变的患者,其中前壁心肌梗死患者68例,下壁心肌梗死患者98例。病理性Q波对前壁心肌梗死部位冠状动脉多支血管病变诊断的灵敏度高于下壁心肌梗死部位[88.56%vs.71.20%],特异度低于下壁心肌梗死部位[69.12%vs.92.86%],差异有统计学意义(P<0.05);病理性Q波对不同梗死部位冠状动脉多支血管病变诊断的阳性预测值、阴性预测值以及准确性差异无统计学意义(P>0.05)。结论:静息心电图II、III及a VF导联病理性Q波诊断前壁心肌梗死部位冠状动脉多支血管病变灵敏度高,诊断下壁心肌梗死部位的特异性高,可为临床诊断冠状动脉多支血管病变提供参考。
Objective To explore the clinical value of pathological Q waves in resting electrocardiogram Ⅱ,Ⅲ and a VF in the diagnosis of multivessel lesions of coronary artery disease. Method The data of 527 cases with myocardial infarction were retrospectively analyzed,they were invided into anterior wall myocardial infarction and inferior wall myocardial infarction according to the myocardial infarction site. Comparison of diagnistic value of pathological Q waves to different infarct site when the results of coronary angiography was ＂gold standard＂. Results The results of coronary angiography in patients with myocardial infarction showed that 304（ 57. 69%） were anterior wall myocardial infarction while 223（ 42. 31%） of inferior wall myocardial infarction. There were 361（ 68. 50%） of multivessel lesions including 236 of anterior wall myocardial infarction and 125 of inferior wall myocardial infarction,when 166（ 31. 50%） of non- multivessel lesions including 68 of anterior wall myocardial infarction and 98 of inferior wall myocardial infarction. The sensitivity of pathological Q waves for multivessel lesions in anterior wall myocardial infarction was higher than that of inferior wall myocardial infarction[88. 56% vs. 71. 20% ],the specificity was lower than that of inferior wall myocardial infarction [69. 12% vs. 92. 86% ],the difference was statistically significant（ P〈0. 05）. There was no statistical significance on difference of positive predictive value,negative predictive value and accuracy in different myocardial infarction in the diagnosis of multivessel lesions（ P〈0. 05）. Conclusion The pathological Q waves in resting electrocardiogram II,III and a VF has high sensitivity to diagnose multivessel lesions in anterior wall myocardial infarction and high specificity in inferior wall myocardial infarction.
出处
《吉林医学》
CAS
2016年第5期1087-1089,共3页
Jilin Medical Journal
