【摘要】 目的:探讨12导联心电图平面QRS-T夹角与冠心病(CHD)的相关性及对其的诊断价值。方法:选择2014年6月～2016年10月于我院接受冠脉造影者140例为研究对象。根据冠脉造影结果,研究对象被分为健康对照组(70例)和CHD组(70例),而CHD组又进一步分为不稳定型心绞痛(UAP)组(40例)和急性心肌梗死(AMI)组(30例)。采用Gensini积分评估各组冠脉病变严重程度,比较各组QRS-T夹角、Gensini积分。分析QRS-T夹角与Gensini积分的相关性,采用受试者工作特征曲线(ROC)分析QRS-T夹角对CHD的诊断价值。结果:与健康对照组比较,CHD组QRS-T夹角[(40.16±10.33)°比(93.23±12.25)°]、QRS-T夹角>90°比例(28.57%比85.71%)、Gensini积分[0分比(38.29±9.36)分]均显著升高,P均=0.001;与UAP组比较,AMI组QRS-T夹角和Gensini积分均显著升高,P均=0.001。Pearson相关分析显示CHD组QRS-T夹角与Gensini积分呈显著正相关(r=0.693,P=0.001)。ROC曲线显示,以QRS-T夹角>90°为切点,其诊断CHD的灵敏性为85.71%、特异性为71.43%、准确性为78.57%。结论:心电图平面QRS-T夹角与冠心病严重程度呈显著正相关,对冠心病的诊断具有一定的价值,值得推广。更多还原

【Abstract】 Objective:To explore correlation between 12-lead ECG plane QRS-T angle and coronary heart disease(CHD)and its diagnostic value for CHD.Methods:A total of 140 subjects,who received coronary angiography(CAG)in our hospital from Jun 2014 to Oct 2016,were selected.According to CAG outcome,they were divided into healthy control group(n=70)and CHD group(n=70).CHD group was further divided into unstable angina pectoris(UAP)group(n=40)and acute myocardial infarction(AMI)group(n=30).Gensini score was used to assess severity of coronary disease in all groups,and QRS-T angle and Gensini score were compared among all groups.Correlation between QRS-T angle and Gensini score was analyzed.Receiver operating characteristic curve(ROC)was used to analyze diagnostic value of QRS-T angle for CHD.Results:Compared with healthy control group,there were significant rise in QRS-T angle[(40.16±10.33)°vs.(93.23±12.25)°],percentage of QRS-T angle>90°(28.57%vs.85.71%)and Gensini score[0 vs.(38.29±9.36)scores]in CHD group,P=0.001 all;compared with UAP group,there were significant rise in QRS-T angle and Gensini score in AMI group,P=0.001 both.Pearson correlation analysis indicated that QRS-T angle was significant positively correlated with Gensini score in CHD group(r=0.693,P=0.001).ROC indicated that when QRS-T angle>90 was treated as cutoff point,its sensitivity,specificity and accuracy diagnosing CHD were 85.71%,71.43% and 78.57% respectively.Conclusion:ECG plan QRS-T angle is significant positively correlated with CHD severity,which possesses certain diagnostic value for CHD.It is worth extending.更多还原