摘要
目的探讨究ST-T段改变患者心电瀑布图形态特征及其对心血管疾病的预测价值。方法选择2020年6月1日至2022年6月1日在该院进行心电瀑布图及传统心电图检查的疑似心脏病患者970例作为研究对象,根据24 h动态心电图分为ST-T段改变216例及正常心电图754例。分析心电图ST段下降、ST段抬高、T波低平、T波负向、T波正向、T波双向波长中心电瀑布图形态特征;采用一致性检验法检测心电瀑布图、常规心电图与24 h动态心电图诊断ST-T段改变的一致性;采用四格表法检测心电瀑布图、常规心电图诊断ST-T段改变的灵敏度、特异度。结果正常心电图受检者心电图波及波群TP带、P峰带、PR峰、QPS带、ST带、T峰带、TP带心电瀑布图特征主要表现浅蓝色、亮蓝色、蓝色、红色/黄色/橙色、蓝色、蓝色/亮蓝色、浅蓝色。216例ST-T段改变患者中,156例患者心电图显示为ST段下降,其中68例患者为T波负向,心电瀑布图表现为深蓝色62例(91.18%)、蓝黑色6例(8.82%);73例患者为T波正向,心电瀑布图表现为蓝黑色66例(90.41%)、深蓝色7例(9.59%)。60例患者心电图显示为ST段抬高,其中51例患者为T波正向,心电瀑布图表现为亮蓝色43例(84.31%)、深蓝色6例(11.76%)、淡黄色2例(3.92%)。74例患者存在T波负向,心电瀑布图表现为蓝黑色;124例患者存在T波正向,心电瀑布图随T波幅度呈浅蓝-亮蓝-黄-红改变;12例存在T波低平,心电瀑布图上方随T波幅度呈浅蓝-亮蓝-黄-红改变,下方主要表现为蓝黑色。心电瀑布图诊断ST-T段改变的灵敏度、特异度、准确度分别为96.30%、88.73%、90.41%,常规心电图诊断ST-T段改变的灵敏度、特异度、准确度分别为83.33%、72.68%、75.05%。一致性检验结果显示,心电瀑布图与24 h动态心电图诊断ST-T段改变的一致性极强,常规心电图与24 h动态心电图诊断ST-T段改变的一致性较好。结论ST-T改变患者心电瀑布图具有明显特征性改变,其在诊断心血管疾病方面的价值优于常规心电图,可推广应用。
Objective To investigate the morphological characteristics of electrocardiogram(ECG)waterfall in patients with ST-T changes and its predictive value in patients with cardiovascular disease.Methods A total of 970 patients with suspected heart disease who both performed ECG waterfall and conventional ECG in the hospital from June 1 st 2020 to June 1 st 2022 were selected as observation subjects.216 patients with ST-T segment alteration and 754 patients with normal ECG were classified according to 24 h dynamic ECG.The morphological characteristics of ECG ST-segment decrease,ST-segment elevation,T-wave hypoplasia,T-wave negative,T-wave positive and T-wave bidirectional wavelength centered ECG waterfall were analyzed.The consistency test was used to detect the consistency of ST-T segment changes in the ECG waterfall,conventional mode and 24 h ambulatory ECG diagnosis.The sensitivity and specificity of ST-T segment changes diagnosed by ECG waterfall and conventional methods were examined by the four-frame table method.Results The waterfall features of TP band,P-peak band,PR-peak,QPS band,ST band,T-peak band,TP band ECG of normal ECG subjects with ECG wave and wave groups mainly showed light blue,bright blue,blue,red/yellow/orange,blue,blue/bright blue,light blue.Among 216 patients with ST-T segment alteration,156 patients had ST-segment drop,of which 68 patients had negative T waves,with ECG waterfall mainly showing dark blue in 62 cases(91.18%)and blue-black in 6 cases(8.82%),while 73 patients had positive T wave,with ECG waterfall showing blue-black in 66 cases(90.41%)and dark blue in 7 cases(9.59%).The ECG of 60 patients showed ST-segment elevation,of which 51 patients had positive T waves,with ECG waterfall mainly showing bright blue in 43 cases(84.31%),dark blue in 6 cases(11.76%)and light yellow in 2 cases(3.92%).74 patients had negative T waves,mainly showing blue-black;T-wave was positive in 124 patients,with light blue-bright blue-yellow-red changed with T-wave amplitude;T-wave was low in 12 patients,with light blue-bright blue-yellow-red changed with T-wave amplitude above and blue-black below.The sensitivity,specificity and accuracy of diagnosing ST-T segment changed by ECG waterfall were 96.30%,88.73% and 90.41%respectively,and 83.33%,72.68% and 75.05% respectively,by conventional ECG.The results of the consistency examination showed that the agreement between the ECG waterfall and 24 h dynamic ECG for the diagnosis of ST-T segment alteration was extremely strong,and the agreement between the traditional ECG and 24 h dynamic ECG for the diagnosis of ST-T segment alteration was better.Conclusion The ECG waterfall in patients with ST-T alterations has obvious characteristic changes,and its value in diagnosing cardiovascular disease is better than that of the conventional modality,so it is worthy of promotion and application.
作者
王芬
蔺军芳
张录兴
王文龙
张荣
WANG Fen;LIN Junfang;ZHANG Luxing;WANG Wenlong;ZHANG Rong(ECG Examination Center,Xi'an International Medical Center Hospital,Xi'an,Shaanxi 710010,China)
出处
《检验医学与临床》
2024年第3期346-349,共4页
Laboratory Medicine and Clinic
关键词
ST-T改变
心电瀑布图
形态特征
预测价值
ST-T alteration
electrocardiogram waterfall
morphological characteristics
predictive value
