急性肺栓塞患者的心电图改变及临床意义

Clinical diagnostic value of electrocardiogram in acute pulmonary embolism

目的 探讨急性肺栓塞患者的心电图改变及其在临床诊断中的价值.方法 选取2016年3月至2017年12月医院就诊的疑似急性肺栓塞患者72例,均行心电图检查,并以肺血管造影检查结果为金标准,分析心电图诊断急性肺栓塞的临床价值及心电图改变情况.结果 经肺血管造影诊断,72例研究对象中急性肺栓塞65例.心电图检查准确性90.28％,敏感性96.92％,特异性28.57％,阳性预测值92.65％,阴性预测值50.00％;72例患者中心电图在正常范围占5.56％,窦性心动过速占72.22％,室性早搏占2.78％,电轴右偏占12.50％,avR主波向上及右束支阻滞占11.11％,肺性P波占5.56％,SⅠQⅡTⅢ占13.89％,V1-3T波倒置占25.00％,V1-6T波倒置占8.33％.结论 心电图检查在急性肺栓塞临床诊断中有较好的诊断价值,可提高诊断准确性.

Objective To investigate the clinical diagnostic value of electrocardiogram in acute pulmonary embolism （APE）. Methods A total of 72 patients with suspected APE in hospital from March 2016 to December 2017 were selected, all of the patients underwent electrocardiogram examination. The pulmonary angiography results were taken as the gold standards, the clinical diagnostic value of electrocardiogram in APE and electrocardiogram changes were analyzed. Results Sixty-five cases of APE were diagnosed by pulmonary angiography among the 72 cases; the accuracy, sensitivity, specifici- ty, positive predictive value, negative predictive value of electrocardiogram were 90. 28%, 96. 92%, 28.57% , 92. 65%, 50.00% ; the electrocardiogram o~ 5.56% of patients was within the normal range, there were 72. 22% of sinus tachycardia, 2. 78% of ventricular premature beat, 12.50% of right axis deviation, 11.11% of avR upward main wave and right bundle branch block, 5.56% of P-pulmonale, 13.89% of S [ Q ⅡT Ⅲ, 25.00% of V1-3T wave inversion, 8.33% of VI-6T wave inversion. Conclusions The electrocardiogram has better clinical diagnostic value in APE, which can increase the diagnostic accuracy.