| Objective: To investigate a 12-lead ECG in the fragmented QRS complex(Fragmented QRS complexes, f QRS) diagnosing coronary artery disease, to facilitate clinicians by ECG diagnosis of coronary heart disease and non-invasive; 2 binding coronary angiography analysis. different gender patients with coronary heart ECG ST-T changes the relationship between QRS fragmentation and provide a scientific basis for the diagnosis and treatment of coronary heart disease in patients with different gender.Methods: June 2014 ~ January 2016 in our hospital cardiology hospital with heart palpitations, chest pain, chest tightness and other symptoms parallel coronary angiography, patients were enrolled in 423 cases, 360 cases of patients with diagnosed coronary heart disease, mean age 71.3 ± 9.3 years old, were preoperative 12-lead ECG testing, leads 12-lead ECG QRS complex fragmentation occurs through statistics, each lead ST-T changes as well as coronary artery lesions, vascular lesions and the extent of the number of branches etc. Learn f QRS on ECG and coronary heart disease in patients with ST-T changes the characteristics of the correlation analysis f QRS and coronary artery disease, fragmentation investigate the diagnostic value of QRS complex coronary artery disease.Results: All 423 cases of samples selected cases, coronary angiographyconfirmed a total of 360 cases of patients with coronary heart disease, coronary heart disease excluded 63 patients with coronary angiography as the gold standard, the results show: coronary heart disease fragmentation test of the sensitivity of the QRS complex of 60% and specificity of 63.5%; and ST-T changes of coronary heart disease test sensitivity 78.3%, specificity was 84.1%; f QRS merge ST-T changes of coronary heart disease test sensitivity of 51.9% and a specificity of 96.8%; it can be seen, relying solely on the sensitivity and specificity of fragmented QRS wave detecting coronary artery disease are at the middle level, but the combination of ST-T changes in the future, although the sensitivity decreased, but significantly improve the specificity of the three differences in outcome measures between the presence of statistically significant, χ2 = 31.111, P = 0.021. Coronary artery disease increases with the count, f QRS positive rate increased: single vessel disease positive rate of 35.5%, double vessel disease positive rate was 57.3%, multivessel disease positive rate was 86.9%, χ2 = 31.11, P = 0.017, the difference statistically significant. f QRS wave front descending artery, the left circumflex artery, right coronary artery in different vascular lesion detection rate differences: left anterior descending artery lesion detection rate was 51.1%, left circumflex artery lesion detection rate was 63.8%, the right coronary vein lesion detection rate was 65.8%, χ2 = 17.79, P = 0.002, the difference was statistically significant. f QRS in the35-55-year-old male patient electrocardiogram positive rate of 25.6%, ≥56 years positive rate was 64.9%; f QRS in the 35-55 year-old female patient ECG positive rate 29.6% aged ≥56 positive rate 72.4%; χ2 = 5.167, P = 0.143. Tip male and female patients with coronary heart f QRS positive rate was no significant difference, but increases with age, increasing f QRS positive rate. Judging from the number of diseased coronary branches, women with coronary heart disease patients with single-vessel disease is more common, accounting for 55.25% of the total number of female patients with coronary heart disease, double vessel and multivessel disease percentages were 25.17%, 19.58%; male patients with coronary heart disease multivessel disease is more common, accounting for 43.32% of the total number of male patients with coronary heart disease, the percentage of single and double-vessel disease were 19.35%, 37.33%. χ2 = 23.74, P = 0.001. Women T wave changes in patients with coronary heart disease incidence(67.1%) than ST-segment changes incidence(32.9%) male patients with coronary heart disease incidence of ST-segment changes(66.8%) more than the T wave changes incidence(33.2%), χ2 = 11.627, P = 0.001, prompted female patients with T wave changes mainly male patients with ST segment changes based. Increased with the lesion count, f QRS merger of ST-T changes the positive rate of increase: single vessel disease positive rate of 22.3%, double vessel disease positive rate was 62.4%, multivessel disease positive rate was71.3%, χ2 = 41.513, P = 0.001, the difference was statistically significant. Splintered QRS complex merger ST-T changes in male patients with multivessel disease-based, which accounted for 74.7%; female patients with single-vessel-based, which accounted for 77.8%, fragmented QRS wave the combined ST-T changes for single gender coronary heart disease patients with multivessel disease differences in diagnostic yield statistically significant, P1 = 0.047; double-vessel disease was no significant difference, P2 = 0.103.Conclusions: 1. Routine electrocardiogram f QRS appeared and the number of diseased coronary artery and culprit artery has certain correlation, index as a predictor of coronary lesion vessels and culprit artery; 2. Combined with ST-T change and fragmented QRS complex diagnostic positive rate of coronary heart disease than relying solely on ST-T change or fragmented QRS wave diagnosis of coronary heart disease(CHD) positive rate was increased, and with the number of diseased coronary artery increased, diagnosis positive rate increased; 3. merge fragmented QRS complex ST-T changes in male patients with multivessel disease mainly female patients with a single vessel disease based. |
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