心电图、心电向量图与冠状动脉造影结果对比分析

任春霖; 卢小伟; 邱代洲; 李东峰

doi:61-1268/R.20110503.1642.026

心电图、心电向量图与冠状动脉造影结果对比分析

Comparison of electrocardiogram and vectorcardiogram and results of coronary angiography

摘要

摘要: 目的:通过分析心电图(Electrocardiogram，ECG)和心电向量图(Vectorcardiogram，VCG)的改变与冠脉造影（CAG）结果进行对比，探讨ECG、VCG在冠状动脉病变中的诊断价值。方法：选择2008年1月~2009年12月临床拟诊断为冠心病患者108例，行常规ECG、VCG检查，并于1周内进行CAG，对检查结果依据各自的诊断标准进行判定，以CAG为标准诊断法，利用四格表法，计算相关评价真实性的指标并进行比较。结果： ①VCG检测的灵敏度、特异度、准确度显著高于ECG(P<0.05，P<0．01)。②ECG、VCG阳性率与冠脉病变支数组间比较：在单支病变、双支病变中，VCG阳性率明显高于ECG(P<0.05)，左主干或三支病变无统计学意义；组内比较：ECG组左主干或三支病变组较单支病变、双支病变阳性率高(P<0.05，P<0.01)；VCG组左主干或三支病变组较单支病变阳性率高(P<0.05)；与双支病变阳性率比较无统计学意义；③ECG、VCG阳性率与冠脉病变程度组间比较：冠脉病变狭窄50%～69%的VCG阳性率明显高于ECG (P<0.05)，其他两组阳性率比较无统计学意义；组内比较：ECG组冠脉病变狭窄≥90%较50%～69%、70%～89%的阳性率高(P<0.05，P<0.01)； VCG组狭窄≥90%较50%～69%阳性率高（P<0.01)，其他无统计学意义。结论： VCG对冠心病检测价值显著高于ECG。

Abstract: AIM:To explore the value of electrocardiogram (ECG) and vectorcardiogram (VCG) in diagnosing coronary artery lesions by comparing the variations of ECG and VCG with the results of coronary angiography (CAG). METHODS: A total of 108 patients clinically diagnosed with coronary heart disease were recruited from January 2008 to December 2009. Routine ECG and VCG were performed followed by CAG within 1 week. Above results were evaluated by their respective diagnostic criteria. CAG was taken as the diagnostic standard for coronary heart disease and relevant indexes were calculated and evaluated by fourfold table method. RESULTS: Sensitivity, specificity and accuracy of VCG were higher than those of ECG (P<0.05 or P<0.01). For intergroup comparison, the positive rate of VCG was significantly higher than that of ECG in the single- or double-vessel lesions (P<0.05), but no statistical significance was observed in left main-vessel or three-vessel lesions. The positive rate of ECG was significantly higher in left main-vessel or three-vessel lesions than in the single- or double-vessel lesions (P<0.05 or P<0.01) and the positive rate of VCG was significantly higher in left main- or three-vessel lesions than in single-vessel lesions (P<0.05). But no statistical significance was seen between left main-vessel or three-vessel lesions and double-vessel lesions. The positive rate of VCG was significantly higher than ECG in coronary artery stenosis ranging from 50 to 69% (P<0.05), but no statistical significance in other groups. For intra-group comparison, the positive rate of ECG was significantly higher in coronary artery stenosis (90%) than that in coronary artery stenosis ranging from 50 to 69% and 70 to 89% (P<0.05 or P<0.01). The positive rate of VCG was significantly higher in coronary artery stenosis 90% than that in coronary artery stenosis ranging from 50 to 69% (P<0.01), but no statistical significance was found in other subgroups. CONCLUSION: The value of VCG is significantly higher than that of ECG in the diagnosis of coronary artery disease.

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