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目的:通过分析心电图(Electrocardiogram,ECG)和心电向量图(Vectorcardiogram,VCG)的改变与冠脉造影(CAG)结果进行对比,探讨ECG、VCG在冠状动脉病变中的诊断价值。方法:选择2008年1月~2009年12月临床拟诊断为冠心病患者108例,行常规ECG、VCG检查,并于1周内进行CAG,对检查结果依据各自的诊断标准进行判定,以CAG为标准诊断法,利用四格表法,计算相关评价真实性的指标并进行比较。结果:①VCG检测的灵敏度、特异度、准确度显著高于ECG(P<0.05,P<0.01)。②ECG、VCG阳性率与冠脉病变支数组间比较:在单支病变、双支病变中,VCG阳性率明显高于ECG(P<0.05),左主干或三支病变无统计学意义;组内比较:ECG组左主干或三支病变组较单支病变、双支病变阳性率高(P<0.05,P<0.01);VCG组左主干或三支病变组较单支病变阳性率高(P<0.05);与双支病变阳性率比较无统计学意义;③ECG、VCG阳性率与冠脉病变程度组间比较:冠脉病变狭窄50%~69%的VCG阳性率明显高于ECG(P<0.05),其他两组阳性率比较无统计学意义;组内比较:ECG组冠脉病变狭窄≥90%较50%~69%、70%~89%的阳性率高(P<0.05,P<0.01);VCG组狭窄≥90%较50%~69%阳性率高(P<0.01),其他无统计学意义。结论:VCG对冠心病检测价值显著高于ECG。
OBJECTIVE: To evaluate the diagnostic value of ECG and VCG in the diagnosis of coronary artery disease by analyzing the changes of electrocardiogram (ECG) and vector cardiogram (VCG) compared with coronary angiography (CAG). Methods: From January 2008 to December 2009, 108 cases of patients with CHD were enrolled in this study. They were examined by routine ECG and VCG. CAG was performed within 1 week. The results of the tests were judged according to their respective diagnostic criteria. The CAG For the standard diagnostic method, the use of four grid table method to calculate the relevant evaluation of the authenticity of the indicators and compared. Results: ① The sensitivity, specificity and accuracy of VCG detection were significantly higher than those of ECG (P <0.05, P <0.01). The positive rate of VCG and VCG between the two groups was significantly higher than that of ECG (P <0.05), and no significant difference was found between the two groups (P <0.05, P <0.01). The positive rate of left main branch or three lesion in ECG group was significantly higher than that of single lesion (P <0.05) <0.05). The positive rate of VCG was not significantly different from that of double-vessel disease. (3) The positive rates of VCG and VCG between the two groups were significantly higher than those from ECG (P < 0.05). The positive rates of the other two groups were not statistically significant. In the group comparison, the positive rates of coronary stenosis ≥90%, 50% ~ 69%, 70% ~ 89% were higher in ECG group (P <0.05, P < 0.01). The positive rate of stenosis≥90% in VCG group was higher than that in 50% -69% (P <0.01), while the others were not statistically significant. Conclusion: The detection of coronary heart disease by VCG is significantly higher than that of ECG.