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目的通过对不同年龄疑诊或确诊为冠心病患者的症状、病程、心电图(ECG)STT改变、血液生化与冠状动脉造影(CAG)结果分别进行对比分析,旨在评价应用ECG与CAG对不同年龄冠心病患者的诊断价值。方法在疑诊或确诊为冠心病并进行CAG的患者中抽取216例进行回顾性分析。将其分为非老年组(45~59岁)及老年组(≥60岁);按照有ECGSTT改变伴典型心前区闷痛和不伴典型心前区闷痛者分为A、B组。对比分析不同年龄组A、B组间CAG与ECG的改变,及其心前区闷痛的病程、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、血小板(PLT)、纤维蛋白原(Fg)。结果非老年组CAG阳性A组占888%,B组占563%,差异有统计学意义(P<001)。老年组CAG阳性A组占908%,B组占800%,差异无统计学意义(P<005)。老年A组TC、LDLC、Fg明显高于B组,非老年A组TC、TG、LDLC、Fg明显高于B组(均为P>005或P>001)。老年组患者心前区闷痛病史明显长于非老年组,多支病变明显多于单支病变。结论ECGSTT改变伴典型心前区闷痛在诊断冠心病中的价值优于仅有STT改变者,特别是对于非老年患者单纯STT改变不能作为诊断冠心病的依据,应结合患者典型的心前区闷痛症状、病程、TC、TG、LDLC、Fg结果综合作出判断;CAG可提高冠心病的诊断符合率,
OBJECTIVE: To compare and analyze the symptoms, course of disease, ECG STT changes, blood biochemistry and coronary angiography (CAG) in patients with suspected or diagnosed coronary heart disease of different ages. The aim is to evaluate the effect of ECG and CAG on different age Diagnostic value of coronary heart disease. Methods 216 patients with suspected or confirmed coronary artery disease and CAG were retrospectively analyzed. The patients were divided into non-elderly group (45-59 years old) and elderly group (≥60 years old). Patients in group A and B were divided into two groups according to ECGSTT changes with typical precordial tenderness and no typical complicated anterior platypithecus. The changes of CAG and ECG in different age groups A and B were compared and analyzed. The course of the pain in precordial area, serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC) LDL, PLT, Fg. Results Non-elderly CAG positive group A accounted for 888%, B group accounted for 563%, the difference was statistically significant (P <001). The elderly group CAG positive A group accounted for 908%, B group accounted for 800%, the difference was not statistically significant (P <005). TC, LDLC and Fg in elderly A group were significantly higher than those in B group. TC, TG, LDLC and Fg in non-elderly group A were significantly higher than those in group B (all P> 005 or P> 001). Senile patients with presymptomatic dull pain history was significantly longer than non-elderly group, multi-vessel disease was significantly more than single-vessel disease. Conclusion ECGSTT changes with typical precordial stuffy pain in the diagnosis of coronary heart disease is better than the value of only STT changes, especially for non-elderly patients with simple STT changes can not be used as the basis for the diagnosis of coronary heart disease, patients should be combined with the typical precordial Painful symptoms, duration, TC, TG, LDLC, Fg results to make a comprehensive judgment; CAG can improve the diagnostic accuracy of coronary heart disease,