ECG ST-T changes , namely ST segment horizontal or downward sloping depression ≥ 0.05mv, available with or without T wave flat , inverted, is a symbol of change in coronary heart disease . Well, ECG ST-T changes , there is certainly coronary stenosis Sclerosis with it? With the development of coronary intervention , coronary angiography (CAG) has become the gold standard for the diagnosis of coronary heart disease , ECG ST-T changes diagnosis
心电图的ST-T变更,即ST段水准型或下斜型压低≥0.05mv，可伴或不伴有T波低平、倒置，是冠心病的微记性变动。那末，心电图有ST-T变更就一定存在冠状动脉粥 硬化伴管腔狭小吗？Questioned the reliability of coronary heart broken . In this paper, 206 cases of ECG ST-T changes in patients undergoing coronary angiography, and the results were analyzed to investigate the ST-T changes in the diagnosis of coronary artery disease .对象：挑选2007年元月到2008年三月我院住院病人核心电图有ST-T变更，开始阶段的诊为冠心病的患者206例，施行18导联心电图、12导联同步全部信息动态心电图、冠脉造影查缉。
1 Materials and Methods
1.1 PARTICIPANTS: January 2007 to March 2008 in our hospital inpatients ECG ST-T changes , the initial diagnosis of coronary artery disease in patients with 206 cases in 18 -lead ECG , 12- lead simultaneous holographic Holter coronary angiography. 124 cases were male , 82 females , aged 43 to 84 years (54.3 ± 14.2) years old. According to the existence of dynamic ST-T changes into two groups. Group A ( 67 cases ) : chest tightness, chest pain and other symptoms of angina episodes or 24 -hour ambulatory ECG showed ST-T with dynamic changes [ST -segment depression or T wave is more and more obvious flat , inverted ( change ≥ 1mm, duration of at least 1 minute ) , or ST-T pseudo- normalization ]; B group ( 139 cases ) : with or without symptoms of angina , angina onset of symptoms or 24- hour ambulatory ECG showed ST-T has no dynamic changes .
1.2 Method: the day of admission , the next day , the first three days of the tracings once 18 -lead ECG ( standard 12-lead ECG plus V7 ~ 9, V3R ~ 5R); any symptoms of angina attack , then attack tracings 18 lead ECG ; hospital 5 days 24 hours 12 line holographic dynamic lead simultaneous ECG ST-T changes in patients confirmed the existence of dynamic change . One week experts coronary angiography by the Judkins method, the degree of stenosis with a diameter of France , said at least one lesion > 50% of coronary heart disease.
1.3 Statistical Methods: compliance rate in each group were compared using Χ ² test , P <0.05 was considered statistically significant.
2 Results
2.1 206 cases of ECG ST-T changes in patients with ST-T based on the existence of the dynamic changes are pided into two groups, and by coronary angiography , the following results ( Table 1 ) :
Table 1 ST-T changes the value in the diagnosis of coronary artery disease
Group number of cases diagnosed as the number of cases of CHD in the number of cases diagnosed with non- compliance rate of coronary heart disease ( % )
A 67 46 21 68.7
B 139 47 92 33.8
Note: The compliance rate between the two groups χ ² = 22.15, P <0.005
2.2 ECG ST-T changes are dynamically changing dynamics in patients with and without coronary heart disease compared with patients diagnosed compliance rate were significantly different.
3 Discussion
Clinically through ECG ST-T changes diagnosing coronary artery disease is the most common and easiest method, but ECG "pseudo Change" easily lead to decreased diagnostic accuracy of coronary heart disease . Our results show that no dynamic ST-T changes in line with the diagnosis of coronary heart disease rate was 33.8% .
ECG ST-T changes in patients with coronary stenosis does not necessarily exist . This observation to dynamically change without ST-T patients mostly by high blood pressure , a variety of cardiomyopathy, cardiac autonomic nervous disorder . ① hypertensive patients because of left ventricular pressure increased, decreased blood perfusion and endocardial ventricular repolarization effects caused similar coronary ischemic ST-T changes the most common. ② variety of cardiomyopathy due to myocardial cells suffer irreversible damage undone and the emergence of a very incomplete injury current leads ST-T changes . ③ women diagnosed with coronary heart disease patients with chest pain false positive rate may be related to autonomic dysfunction and elderly postmenopausal women estrogen gradually reduced, resulting in endothelial dysfunction related to the development of atherosclerosis .
The ST-T has dynamic changes, especially as angina pectoris with ST-T changes in the diagnosis of coronary artery disease dynamics very meaningful . Because angina pectoris , atherosclerosis, coronary spasm stenosis , occlusion or myocardial oxygen demand increased, causing aggravation of myocardial ischemia , leading to myocardial injury current occurs , secondary depolarization repolarization abnormalities and damage , which appeared ST-T dynamic change
So the ECG ST-T changes in patients with early coronary angiography to be a clear diagnosis for proper treatment.