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目的与冠脉造影比较,探讨动态心电图对不稳定性心绞痛诊断的敏感性和特异性。方法选择80例不稳定性心绞痛(UAP)患者,入院一周内分别做冠状动脉造影(CAG)和12导动态心电图(DCG)检查。通过CAG和DCG结果对比,评价12导DCG诊断不稳定性心绞痛ST段下移的敏感性和特异性,并分析冠状动脉狭窄支数与心肌缺血程度的关系。结果与CAG比较,12导DCG诊断UAP ST段下移的敏感性和特异性分别为80.3%和84.2%。冠状动脉多支病变组与单支病变组比较,多支病变组心绞痛发作次数增加、持续时间延长,ST段下移幅度及TIB增加(P均<0.01)。结论 12导DCG能对心肌缺血部位提供较准确评估,是诊断UAP无创经济的一种检查手段。
Objective To compare the sensitivity and specificity of Holter in the diagnosis of unstable angina pectoris. Methods Eighty patients with unstable angina pectoris (UAP) were enrolled in this study. Coronary angiography (CAG) and 12-lead dynamic electrocardiogram (DCG) were performed within one week after admission. The sensitivity and specificity of 12-lead DCG in the diagnosis of ST-segment elevation in patients with unstable angina pectoris were evaluated by CAG and DCG results. The relationship between coronary stenosis count and myocardial ischemia was analyzed. Results Compared with CAG, the sensitivity and specificity of 12-lead DCG in the diagnosis of UAP ST segment were 80.3% and 84.2% respectively. Compared with single-vessel lesion group, the incidence of angina pectoris in multi-vessel lesion group was prolonged, the duration of ST segment depression and TIB increased (all P <0.01). Conclusions The 12-lead DCG can provide a more accurate assessment of myocardial ischemia and is a diagnostic tool for noninvasive UAP diagnosis.