摘要
目的探究心电散点图配合动态心电图用于诊断冠心病患者心律失常的临床价值。方法选取2022年1月至2022年12月在本院确诊为冠心病且疑似心律失常的1500例患者,均行常规心电图、心电散点图和动态心电图检查,以临床诊断作为金标准,比较不同诊断方式诊断心律失常的结果;分析不同类型心律失常患者心电散点图B线斜率;采用Kappa一致性分析不同诊断方式诊断心律失常与金标准的一致性。结果974例心率失常患者经确诊为室上性早搏524例,心房颤动124例,室内差异传导89例,室性早搏237例。动态心电图诊断检出率为72.3%,心电散点图诊断检出率为83.4%,心电散点图配合动态心电图诊断检出率为94.6%,差异有统计学意义(P<0.05);经心电散点图检查,室上性早搏患者及室性早搏患者B线斜率与心房颤动、室内差异传导患者B线斜率比较,室上性早搏患者B线斜率最大,室性早搏患者B线斜率最小,差异有统计学意义(P<0.05);而心房颤动患者B线斜率与室内差异传导患者B线斜率比较,差异无统计学意义(P>0.05);动态心电图检测心率失常的灵敏度为72.3%,心电散点图检测心律失常的灵敏度为83.4%,心电散点图配合动态心电图检测心律失常的灵敏度为94.6%。结论在冠心病患者心律失常的临床诊断中,心电散点图配合动态心电图进行诊断的灵敏度、特异度及准确率高,操作简便,具有较高的检测价值。
Objective To explore the clinical value of combining electrocardiography with dynamic electrocardiogram in diagnosing arrhythmia in patients with coronary heart disease.Methods 1500 patients diagnosed with coronary heart disease and suspected arrhythmia in our hospital from January 2022 to December 2022 were selected,all of whom underwent routine electrocardiogram,electrocardiogram scatter plot,and dynamic electrocardiogram examinations.Clinical diagnosis was used as the gold standard,and the results of different diagnostic methods for arrhythmia were compared.The slope of B-line in electrocardiogram scatterplots of patients with different types of arrhythmias was analyzed,and Kappa consistency analysis was used to assess the consistency between different diagnostic methods for diagnosing arrhythmia and the gold standard.Results Among the 974 patients with arrhythmia,524 were diagnosed with supraventricular premature beats,124 with atrial fibrillation,89 with ventricular differential conduction,and 237 with ventricular premature beats.The detection rate of dynamic electrocardiogram diagnosis was 72.3%,the detection rate of electrocardiogram scatter plot diagnosis was 83.37%,and the detection rate of electrocardiogram scatter plot combined with dynamic electrocardiogram diagnosis was 94.6%,with a statistically significant difference(P<0.05).According to the electrocardiogram scatter plot examination,the B-line slope of patients with supraventricular premature beats and ventricular premature beats was compared with that of patients with atrial fibrillation and indoor differential conduction.The B-line slope of patients with supraventricular premature beats was the highest,while that of patients with ventricular premature beats was the lowest,with statistical significance(P<0.05).However,there was no statistically significant difference in the B-line slope between patients with atrial fibrillation and those with indoor differential conduction(P>0.05).The sensitivity of dynamic electrocardiogram for detecting arrhythmia is 72.3%,the sensitivity of electrocardiogram scatter plot for detecting arrhythmia is 83.4%,and the sensitivity of electrocardiogram scatter plot combined with dynamic electrocar-4diogram for detecting arrhythmia is 94.6%.Conclusion In the clinical diagnosis of arrhythmia in patients with coronary heart disease,the combination of electrocardiography with dynamic electrocardiogram has high sensitivity,specificity,and accuracy,simple operation,and high detection value.
作者
张叶杭
牛向东
刘晓玲
Zhang Yehang;Niu Xiangdong;Liu Xiaoling(The Room of ECG,Zhengzhou University Fifth Affiliated Hospital,Henan 450000,China)
出处
《实用医学影像杂志》
2023年第6期421-424,共4页
Journal of Practical Medical Imaging
关键词
动态心电图
冠心病
心律失常
心电散点图
临床价值
Dynamic electrocardiogram
Coronary heart disease
Arrhythmias
Electrocardiogram scatter plot
Clinical value
