24h心电图与常规心电图诊断冠心病心律失常的临床效果

Clinical effect on the diagnosis of coronary heart disease witharrhythmia by 24 hours electrocardiogram and routine electrocardiogram

目的探讨24 h心电图与常规心电图诊断冠心病心律失常的临床效果。方法选取2013年1月~2015年12月我院收治且经冠状动脉造影诊断被确诊的120例冠心病患者作为研究对象,所有患者均接受常规心电图、24 h心电图检查,分析两种心电图检查方法对心律失常的检出情况,计算两种心电图检查方法对心律失常的诊断灵敏度、特异度、准确度,并比较两种心电图检查方法对不同心律失常表现的检出率。结果常规心电图对冠心病心律失常的诊断灵敏度、特异度、准确度分别为69.52%、33.33%、65.00%,24 h心电图对冠心病心律失常的诊断灵敏度、特异度、准确度分别为82.86%、73.33%、81.67%,差异有统计学意义（P〈0.05）。与常规心电图比较,24 h心电图对室性期前收缩二联及三联律、室性期前收缩成对、房性期前收缩二联及三联律、房性期前收缩成对的检出率均明显升高（P〈0.05）。结论在冠心病心律失常的临床诊断中,采用24 h心电图诊断的准确性较常规心电图更高,其诊断价值显著,可作为冠心病心律失常的首选诊断方法。

Objective To explore the clinical effect of 24 hours electrocardiogram and routine electrocardiogram in the diagnosis of coronary heart disease witharrhythmia.Methods From January 2013 to December 2015,120 cases of patients with coronary heart disease who diagnosed by coronary angiography diagnosis in our hospital were selected as the object of the study,all patients underwent routine electrocardiogram and 24 hours ambulatory ECG,two kinds of electrocardiogram inspection methods for arrhythmia detection were analyzed,the arrhythmia diagnostic sensitivity,specificity,accuracy,detection rate of two kinds of electrocardiogram inspection methods were calculated,and the different arrhythmia performance of two kinds of electrocardiogram inspection methods were compared.Results The electrocardiogram（ECG） on arrhythmia of coronary heart disease diagnostic sensitivity,specificity and accuracy were 69.52%,33.33%,65.00%,24 hours electrocardiogram on arrhythmia of coronary heart disease diagnostic sensitivity, specificity and accuracy were 82.86%,73.33% and 81.67%,two groups of difference compared with statistical significance（P〈0.05）.Compared with the conventional ECG,24-hour electrocardiogram of ventricular premature contraction second and bigeminy,ventricular premature contraction in pairs,room sex period before the second shrinkage and trigeminy, atrial premature beats in pairs of detection rate were significantly higher（P〈0.05）.Conclusion In the clinical diagnosis of coronary heart disease arrhythmia, the accuracy of 24 hours of ECG diagnosis is higher than the conventional ECG,and its diagnostic value is significant,can be used as the first choice of diagnosis of coronary heart disease arrhythmia.