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目的 探讨心磁图法对冠心病(CHD)患者的诊断价值,并与心电图(ECG)及超声心动图(UCG)作一比较。方法 应用非屏蔽室内的德国SQUID公司的7通道心磁图仪(MCG7),分别检测82例CHD患者(冠状动脉造影至少有一支血管狭窄≥70％)和116例健康人的心磁图和电流密度分布图,分析两个定量指标:①R-max/T-max比值:即电流密度分布图中R波与T波的最大电流密度矢量值的比值。②R值:异常的心磁图所占的百分比。结果 CHD组的R-max/T-max比值(6.17±4.01)显著高于健康对照组(3.73±1.41)(P<0.001);CHD组的R值为(67.27±28.75)％,对照组为(34.96±19.09)％,两组比较差异有显著性(P<0.001)。82例冠心病患者中,MCG出现异常改变的患者有67例(81.7％),ECG出现缺血改变(异常Q波及ST-T改变)的患者有37例(45.1％),超声心动图检出有节段性室壁活动异常的患者有34例(41.5％),心磁图对冠心病诊断的阳性率显著高于心电图及超声心动图(P<0.001)。结论 具有精细数据分析的心磁图对冠心病患者具有较高的诊断价值,且优于ECG及UCG。
Objective To investigate the diagnostic value of magnetocardiography in patients with coronary heart disease (CHD) and to compare with electrocardiogram (ECG) and echocardiography (UCG). Methods The unscented SQUID 7-channel magnetocardiograph (MCG7) was used to detect the magnetocardiography and current of 82 CHD patients (at least one coronary artery stenosis≥70%) and 116 healthy subjects Density distribution chart, analysis of two quantitative indicators: ① R-max / T-max ratio: the current density distribution of R wave and T wave maximum current density vector ratio. ② R value: the percentage of abnormal magnetocardiography. Results The R-max / T-max ratio (6.17 ± 4.01) in CHD group was significantly higher than that in healthy control group (3.73 ± 1.41) (P <0.001). The R value in CHD group was (67.27 ± 28.75)%, (34.96 ± 19.09)%, the difference between the two groups was significant (P <0.001). Among 82 patients with coronary heart disease, 67 (81.7%) had abnormal changes of MCG, 37 (45.1%) had ischemic changes of ECG (abnormal Q wave and ST-T changes), and echocardiography There were 34 patients (41.5%) with segmental wall abnormalities. The positive rate of magnetic resonance imaging in diagnosis of coronary heart disease was significantly higher than that of ECG and echocardiography (P <0.001). Conclusions Magnetoencephalography with fine data analysis has high diagnostic value in patients with coronary heart disease, and is superior to ECG and UCG.