摘要
目的探讨动态心电图在冠状动脉粥样硬化性心脏病(冠心病)伴心律失常的患者中的诊断意义。方法选择河南省胸科医院在2019年1月至2021年12月接诊后确诊冠心病且出现异常心率的134例疑似心律失常患者作为研究对象,对患者实施常规心电图检查、动态心电图检查,以临床诊断为基准,对比常规心电图检测、动态心电图检查对冠心病伴有心律失常的患者的诊断的灵敏度、特异度、准确率、阳性预测值、阴性预测值,分析在冠心病患者心律失常诊断中常规心电图检查、动态心电图检查与临床诊断结果的统一性,比较常规心电图检查、动态心电图检查对不同类型心律失常的诊断符合率。结果以临床综合诊断为基准,动态心电图检查对冠心病患者心律失常的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值均高于常规心电图检查(P<0.05)。在冠心病患者心律失常诊断中,动态心电图检测结果与临床诊断结果之间具有高度统一性,而常规心电图检测结果与临床诊断结果之间为中度统一性。动态心电图检测对室性室性期前收缩二联律、三联律、成对室性期前收缩;房性期前收缩二联律、三联律、成对房性期前收缩;房室传导阻滞诊断符合率均优于常规心电图(P<0.05)。结论动态心电图对冠心病患者心律失常具有良好的诊断价值,不仅可灵敏检出冠心病患者的心律失常情况,还可对冠心病患者合并的心律失常类型进行鉴别区分。
【Objective】To explore the diagnostic value of dynamic electrocardiogram in patients with coronary heart disease and arrhythmia.【Methods】A total of 134 cases of patients with suspected arrhythmia who were diagnosed with coronary heart disease and had abnormal heart rate in our hospital from January 2019 to December 2021 were selected as the research object.Routine electrocardiogram(ECG)and ambulatory ECG were performed on the patients,and the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of routine ECG and ambulatory ECG were compared based on the comprehensive clinical diagnosis results.The consistency between routine ECG,dynamic electrocardiogram(DCG)and clinical comprehensive diagnosis results in the diagnosis of arrhythmia in patients with coronary heart disease was analyzed,and the diagnostic coincidence rates of routine ECG and DCG for different types of arrhythmia was compared.【Results】Taking the comprehensive clinical diagnosis results as the gold standard,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ambulatory electrocardiogram in patients with coronary heart disease were higher than those of routine electrocardiogram(P<0.05).In the diagnosis of arrhythmia in patients with coronary heart disease,there was a high degree of consistency between dynamic electrocardiogram and clinical comprehensive diagnosis,while the consistency between routine electrocardiogram and clinical comprehensive diagnosis was moderate.The diagnostic coincidence rates of ambulatory electrocardiogram in the diagnosis of ventricular extrasystole duplex and triad,ventricular extrasystole pair,atrial extrasystole duplex and triad,atrial extrasystole pair and atrioventricular block were higher than that of conventional electrocardiogram(P<0.05).【Conclusion】Dynamic electrocardiogram has a good diagnostic value for arrhythmia in patients with coronary heart disease.It can not only sensitively detect the arrhythmia in patients with coronary heart disease,but also differentiate the types of arrhythmia in patients with coronary heart disease.
作者
胡萍
吴志红
HU Ping;WU Zhihong(Cardiopulmonary Function Department,Henan Provincial Chest Hospital(Chest Hospital of Zhengzhou University),Zhengzhou,Henan 450000,China)
出处
《中国医学工程》
2023年第6期75-79,共5页
China Medical Engineering
基金
河南省医学科技攻关计划项目(LHGJ20200210)。
关键词
冠心病
心律失常
诊断
常规心电图
动态心电图
coronary heart disease
arrhythmia
diagnosis
routine electrocardiogram
dynamic electrocardiogram
