王晓萍 王志荣

[摘要] 目的 探討心电图联合心脏彩超检查对冠心病的诊断价值。方法 方便选择2017年1月—2018年12月期间在该院行冠脉造影检查的80例疑似冠心病患者，根据患者冠脉造影前检查项目分为心脏彩超组和心电图+心脏彩超组，各40例。两组患者冠脉造影结束后，统计两组冠心病确诊情况，同时分析两组患者心电图和心脏彩超检查结果，以冠脉造影诊断结果为依据，分析两种检查方式对冠心病诊断的灵敏度、特异度和准确率。结果 心脏彩超组检查对冠心病诊断灵敏度（86.11%）、特异度（50.00%）和准确率（82.50%）。心电图+心脏彩超组检查对冠心病诊断灵敏度（94.29%）、特异度（80.00%）和准确率（92.50%）。心电图+心脏超声检查诊断灵敏度和准确率均略高于心脏彩照，但是差异无统计学意义（χ2=1.336、1.034，P=0.529，0.678）。心电图+心脏彩超组特异度显著高于单纯心脏彩超组，差异有统计学意义（χ2=4.638，P=0.021）。 结论 心电图联合心脏彩超对冠心病的诊断可达到较高的准确率，且心电图+心脏彩超特异度相对较高，有利于冠心病鉴别诊断，可作为重要方法。

[关键词] 心电图;心脏彩超;冠心病;诊断价值

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2019）08（c）-0189-03

[Abstract] Objective To investigate the diagnostic value of electrocardiogram combined with echocardiography in the diagnosis of coronary heart disease. Methods Convenient selected eighty patients with suspected coronary heart disease who underwent coronary angiography in our hospital from January 2017 to December 2018 were enrolled. According to the pre-coronary angiography， the patients were divided into the heart color ultrasound group and the electrocardiogram + cardiac color ultrasound group. 40 cases in each group After coronary angiography， the two groups were diagnosed with coronary heart disease. The results of electrocardiogram and echocardiography were analyzed. The sensitivity， specificity and accuracy of the two examination methods for the diagnosis of coronary heart disease was analyzed based on the results of coronary angiography. Results The sensitivity of the cardiac color Doppler ultrasound examination for coronary heart disease （86.11%）， specificity （50.00%） and accuracy （82.50%）. The sensitivity of electrocardiogram + echocardiography in the diagnosis of coronary heart disease （94.29%）， specificity （80.00%） and accuracy （92.50%）. The sensitivity and accuracy of electrocardiogram + echocardiography were slightly higher than that of heart color， but there was no significant difference， no statistical significance （χ2=1.336，1.034，P=0.529，0.678）. The specificity of the electrocardiogram + heart color ultrasound group was significantly higher than that of the simple heart color ultrasound group， the difference was statistically significant （χ2=4.638，P=0.021）. Conclusion Electrocardiogram combined with cardiac color Doppler ultrasound can achieve high accuracy in the diagnosis of coronary heart disease， and the specificity of electrocardiogram + cardiac color Doppler ultrasound is relatively high， which is conducive to the differential diagnosis of coronary heart disease， and can be used as an important method.

[Key words] Electrocardiogram; Cardiac color Doppler; Coronary heart disease; Diagnostic value

冠心病是影响我国国民生命健康安全的重要心脑血管疾病，也是导致临床最常见的心脑血管疾病之一。冠心病与多种慢性疾病存在紧密联系，尽早确诊，采取规范治疗措施，可有效改善患者预后，降低急性心血管事件风险[1-2]。心电图和心脏彩超是冠心病诊断的主要筛查技术，两者临床应用广泛……