应用动态心电图预测冠心病近期不良事件

The value of 12 lead dynamic electrocardiogram in the diagnosis of coronary heart disease and its predictive value for recent adverse cardiac events

目的探讨十二导联动态心电图(AECG)在诊断冠心病(CHD)中的价值及对近期不良心脏事件(MACE)的预测价值。方法选取2020年9月至2022年9月108例疑似CHD患者,所有患者均行12导联AECG及冠状动脉造影(CAG)检查,以CAG结果为“金标准”,比较12导联AECG与CAG结果,对确诊患者进行6个月随访,观察近期MACE发生情况,分析影响MACE发生危险因素,Cox回归分析MACE发生的独立预测因子。结果共108例疑似患者经CAG诊断CHD 72例,非CHD 36例,12导联AECG诊断真阳性57例,假阳性13例,假阴性15例,真阴性23例,诊断灵敏度为79.16%、特异度为63.89%、准确率为74.07%;MACE组年龄、冠脉病变支数、心肌缺血发作次数高于无MACE组,且心肌缺血发作次数是近期MACE发生的独立预测因子(P<0.05)。结论十二导联AECG对CHD有较高诊断价值,心肌缺血发作次数可作为临床预测近期MACE发生的有效指标。

Objective To explore the value of 12 lead dynamic electrocardiogram(AECG)in the diagnosis of coronary heart disease(CHD)and its predictive value for recent adverse cardiac events(MACE).Methods one hundred and eight suspected CHD patients were selected from September 2020 to September 2022.All patients underwent 12 lead AECG and coronary angiography(CAG)examinations,with the CAG results as the"gold standard".The 12 lead AECG and CAG results were compared.Confirmed patients were followed up for 6 months to observe the recent occurrence of MACE,analyze the risk factors that affect the occurrence of MACE,and Cox regression analysis was used to independently predict the occurrence of MACE.Results Among the 108 suspected patients,72 were diagnosed with CHD by CAG,36 were non CHD,57 were diagnosed with true positive,13 were false positive,15 were false negative,and 23 were true negative by 12 lead AECG.The diagnostic sensitivity was 79.16%,the specificity was 63.89%,and the accuracy was 74.07%;The age,number of coronary artery lesions,and number of myocardial ischemic attacks in the MACE group were higher than those in the non MACE group,and the number of myocardial ischemic attacks was an independent predictor of recent MACE occurrence(P<0.05).Conclusions Twelve-lead AECG has high diagnostic value for CHD,and the number of myocardial ischemic attacks can serve as an effective indicator for predicting the occurrence of recent MACE in clinical practice.