| Objective:Present methods of coronary heart disease diagnosis can be roughly divided into two major categories of invasive and noninvasive examination,including coronary angiography examination is the most accurate diagnostic criteria of all,to have a check;Electrocardiogram(ECG)is a noninvasive examination method is the most commonly used method of inspection,ECG examination simple operation,good repeatability,no contraindications,and the price is relatively cheap,can serve as an early screening methods of coronary heart disease risk groups,can also be used as in patients with acute myocardial infarction,arrhythmia,such as the critical means of inspection,on clinical widely used.With the breakthrough of the theory of "the solar system" is put forward,the pathogenesis of ischemic heart disease is not limited to the coronary plaque formation theory,but expanded to the myocardial ischemia caused by coronary microcirculation disorder might,for follow-up study provides a new opportunity,coronary angiography "gold standard" questioned.ECG checkup the accuracy of the diagnosis also has a limit,misdiagnosis and missed diagnosis,but through joint exercise test,induced myocardial ischemia,or take the dynamic electrocardiogram(ECG),electrocardiogram(ECG)monitoring in patients with 24 hours change,through the review of patients with angina pectoris symptom onset time compared with electrocardiogram(ECG),a definitive diagnosis.For clinical retrospective study,this study aims to analyze electrocardiogram(ECG)and coronary angiography results conform to the degree of exploration of ECG ST segment level extension value to the diagnosis of coronary heart disease.Methods:Collect the first affiliated hospital of shan xi medical university in December 2012-March 2016,301 cases of hospitalized patients with coronary heart disease(CHD)examination,all patients information including personal basic information,detailed medical history,the laboratory indexes,electrocardiogram(ECG)and coronary angiography examination results,etc.Patient inclusion criteria: is there a chest to chest pain,any proposed diagnosis of coronary heart disease patients,all line of 12-lead electrocardiogram,consult Schamroth method,eliminate the influence of heart rate of ST segment and extended in ST segment level acuity 0.12 seconds and appear in the lead as the positive standard of 2 or more,with ST segment < negative for 0.12 seconds.Coronary angiography with Jenkins method,in multiple projection Angle for selective left,right coronary artery angiography,pathological changes in left main,left anterior descending branch(LAD),left circumflex(LCX),right coronary artery(RCA)3,diagonal branch,blunt edge models are classified as the main branch,with two or more multiple lesions;Fixed stenosis < 50% negative,50% or higher is positive.Exclusion criteria: except myocarditis,cardiomyopathy,pericarditis,valvular disease,with bundle branch block,in patients with chronic myocardial infarction,pulmonary embolism,electrolyte disorder(hypocalcemia),and other diseases caused by secondary ST-t change.According to the results of coronary angiography were divided into CHD group and non CHD group,according to the results of electrocardiogram(ECG)is divided into hold on STc acuity 0.12 s positive group and STc < 0.12 s negative group,two groups result were analyzed.The data of this retrospective study,adopting SPSS19.0 software,measurement data with mean + /-standard deviation,said the differences between the groups with variance analysis;Count data expressed as a percentage,the difference between groups was compared by chi-square test,P < 0.05 meaning.Results:1 Correction in accordance with the STc acuity 0.12 s positive group as the electrocardiogram(ECG),and on STc < 0.12 s as the electrocardiogram(ECG)negative groups.Results coronary heart disease group on STc acuity 0.164 cases of 12 s,non CHD group STc acuity 0.12 s 39 cases,as shown in table 1.Examined the c2 and CHD group and non CHD group STc acuity 0.12 S the emergence of a highly significant difference(c2 = 13.29,P < 0.05,the difference was statistically significant).2 Left coronary artery type advantages there are 26 cases(8.7%);Right coronary artery type advantage in 252 patients(83.7%),balanced type 23 cases(7.6%).3 On STc acuity 0.12 s value to the diagnosis of coronary heart disease,after calculation,STc acuity 0.12 s sensitivity of coronary heart disease diagnosis is 83.6%,the specific degree to 82.6%;Positive likelihood ratio of 5.09,negative likelihood ratio of 0.21;Positive predictive value is 87.2% and negative predictive value was 78.0%;Positive odds ratio 2.66,95% confidence interval(0.17,0.17).As can be seen from the above results,ST c p 0.12 s sensitivity to the diagnosis of coronary heart disease and high positive predictive value.Compared with the patients with coronary heart disease,coronary heart disease patients on STc acuity 0.12 s positive advantage is 2.66 times that of the patients with coronary heart disease(CHD).Area under the ROC curve is 0.625,said use on STc length in the diagnosis of coronary heart disease is accurate,the standard error is 0.034,P = 0.000,95% confidence interval(0.560,0.560).Conclusion:1 CHD group and non CHD group STc acuity 0.12 s the emergence of a highly significant difference.2 Left coronary artery type advantages there are 26 cases(8.7%);Right coronary artery type advantage in 252 patients(83.7%),balanced type 23 cases(7.6%),in line with the results in a previous study. |
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