摘要
目的:探讨动态心电图(DCG)诊断急性冠状动脉综合征(ACS)的临床应用价值。方法:对临床拟诊为ACS的86例患者分别采用DCG和冠状动脉造影(CAG),以CAG检查作为金标准,计算DCG诊断ACS的诊断学指标,对DCG诊断ACS冠状动脉病变支数和狭窄程度的阳性率进行分析。结果:CAG确诊ACS 72例,DCG诊断ACS的灵敏度为87.50%,特异度为85.71%,误诊率14.29%,漏诊率12.50%,阳性预测值96.92%,阴性预测值57.14%,2种方法检查结果呈高度一致性(Kappa指数=0.609,P<0.01)。DCG诊断冠状动脉单支病变阳性率为68.75%,诊断冠状动脉双支病变阳性率为92.59%,诊断三支或左主干病变阳性率为93.10%,差异有统计学意义(P<0.05)。DCG诊断轻度狭窄阳性率为66.67%,诊断中度狭窄阳性率为93.75%,诊断重度狭窄阳性率为95.45%,差异有统计学意义(P<0.01)。结论:DCG诊断与CAG诊断ACS具有较高的一致性,DCG诊断双支病变、三支或左主干病变、中度和重度狭窄的阳性率较高。
Objective：To study of the clinical value of dynamic electrocardiogram（ DCG） in the diagnosis of acute coronary syndrome （ ACS ） . Methods：Eighty-six patients diagnosed by ACS were detected using DCG and coronary angiography （ CAG ） . The DCG diagnosis index for ACS was calculated using CAG examination as the gold standard. The correlation of the number of coronary artery lesion number and degree of stenosis of ACS diagnosed by DCG were analyzed. Results：Seventy-two ACS patients were diagnosed by CAG. The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value of DCG in the diagnosis of ACS were 87. 50%,85. 71%,14. 29%,12. 50%,96. 92% and 57. 14%,respectively. The results of two kinds of methods examination were highly consistent（Kappa=0. 609,P〈0. 01）. The disease positive rates of the single-vessel coronary artery, double vessel coronary artery and three or left main vessel coronary artery of DCG diagnosis were 68. 75%,92. 59% and 93. 10%, respectively,and the differences of whose were statistically significant（P〈0. 05）. The positive rates of mild stenosis,moderate stenosis and severe stenosis of the DCG diagnosis were 66. 67%,93. 75 and 95. 45%,respectively,and the differences of whose were statistically significant（P〈0. 01）. Conclusions：The ACS diagnosed with DCG and CAG is high consistency,the positive rates of DCG in diagnosing the double vessel disease,three or left main vessel disease,and moderate and severe stenosis are high.
出处
《蚌埠医学院学报》
CAS
2016年第10期1285-1287,共3页
Journal of Bengbu Medical College
