目的：探讨静息心电图（ECG）ST-T改变与冠状动脉造影（CAG）检查阳性结果间的相关性。方法对重庆医科大学附属第一医院心内科1173例临床诊断为冠心病（CHD）患者的CAG检查及常规12导联静息ECG检查结果进行对比，分析同一患者两种检查结果的相关性。结果 ECG ST-T改变与CAG检查阳性结果的一致性微弱（Kappa=0.161，P＜0.01）；两种检查阳性率有显著性差异（P＜0.01）；冠脉病变支数不同的各组ECG阳性率差异有显著性（P＜0.01）；随着冠脉病变支数的增加，ECG阳性率有增加的趋势，且这种趋势有统计学意义（P＜0.01）。结论ECG ST-T改变可能部分地预测冠状动脉狭窄，并有显著意义，但与CAG检查相比，对诊断CHD的诊断作用有限，所以临床依据ECG ST-T改变诊断CHD时应慎重，需结合临床症状及其他相关辅助检查。%Objective To investigate the relationship of resting electrocardiogram (ECG) ST-T wave change and posi-tive outcome of coronary angiography (CAG). Methods A comparison was made between CAG results and routine 12-channel resting ECG of 1173 patients diagnosed as coronary heart disease (CHD) clinically in cardiovascular depart-ment of internal medicine in the first affiliated hospital of Chongqing medical university ,and their correlation was ana-lyzed. Results ECG ST-T change was not significantly correlated to the CAG positive outcome (Kappa=0.161,P<0.01);There was significant difference of the positive rates between those two examinations(P<0.01);The ECG positive result rates in different coronary artery lesion groups were significantly different (P<0.01); With the increase of coro-nary artery stenosis number, the positive rate of ECG significantly increased. (P<0.01). Conclusion ECG ST-T wave change might partially predict the coronary artery stenosis, but its clinical utility is limited for CHD diagosis compared with CAG. Therefore,it should be careful to diagnose CHD only according to ECG ST-T change in clinic,and clinical diagnosis shuld be made based on clinical symptom and other examinations.
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