Differential diagnosis study of nonspecific ST-T changes in the elderly population
老年人群非特异性ST-T改变的鉴别诊断研究

摘要

目的 研究老年人群非特异性ST-T改变的鉴别诊断方案，优化老年人群心血管疾病防控策略。方法回顾性分析2024年1月-2025年12月期间本院收治的80例存在非特异性ST-T 改变老年患者的临床资料，收集患者基本信息、病史、症状、相关检查结果，查找非特异性ST-T改变的病因，构建分层鉴别诊断方案。结果 统计研究显示，80例存在非特异性ST-T改变的老年患者中，32例病因是冠心病，占40.00%，高血压性心脏病15（18.75%）例、甲状腺功能异常11（13.75%）例、药物影响9（11.25%）例、电解质紊乱6（7.50%）例、肺部疾病4（5.00%）例、生理性改变3（3.75%）例。结论 分析表明，非特异性ST-T改变是老年人群心电图检查中的常见表现，其原因复杂，临床需结合老年患者症状、病史、检查结果构建分层鉴别诊断方案，减少非必要的重复检查，增强鉴别诊断有效性，避免误诊或漏诊。

Abstract

Objective To investigate the differential diagnostic approach for nonspecific ST-T changes in elderly populations and optimize cardiovascular disease prevention strategies for this demographic.
Methods A retrospective analysis was conducted on clinical data of 80 elderly patients with nonspecific ST-T changes admitted to our hospital from January 2024 to December 2025, including baseline information, medical history, symptoms, and relevant laboratory findings. The etiologies of nonspecific ST-T changes were identified, and a stratified differential diagnostic framework was developed.
Results Statistical analysis revealed that among the 80 elderly patients with nonspecific ST-T changes, 32 cases (40.00%) were attributed to coronary heart disease; 15 cases (18.75%) to hypertensive heart disease; 11 cases (13.75%) to thyroid dysfunction; 9 cases (11.25%) to drug-induced effects; 6 cases (7.50%) to electrolyte disturbances; 4 cases (5.00%) to pulmonary diseases; and 3 cases (3.75%) to physiological variations.
Conclusion   Nonspecific ST-T changes are a common finding in electrocardiographic examinations among elderly individuals due to their complex etiology. A stratified differential diagnostic approach incorporating patient symptoms, medical history, and laboratory findings is essential to minimize unnecessary repeat tests, enhance diagnostic accuracy, and prevent misdiagnosis or missed diagnoses.