心电图和心电向量及彩色多普勒超声心动图在心肌梗死患者中的诊断价值

Clinical diagnostic value of electrocardiogram,vectorcardiography and color doppler echocardiography in patients with myocardial infarction

目的探讨心电图(ECG)、心电向量图(VCG)、彩色多普勒超声心动图(CDEC)在心肌梗死(MI)患者中的诊断价值。方法选择郑州大学第二附属医院2008年4月—2010年8月门诊收治及住院确诊MI患者119例,分别进行心电图、心电向量及彩色多普勒超声心动图检查。结果 AMI组81例,ECG检出59例(72.84%),明显高于VCG 32例(39.51%)和CDEC 9例(11.11%)(χ~2=63.860,P<0.001);OMI组38例,VCG检出22例(57.89%),明显高于ECG 9例(23.68%)和CDEC 11例(28.95%)(χ~2=11.083,P=0.004);CDEC检出5例室壁瘤;ECG与金标准存在一致性(Kappa=0.423,P<0.01),但吻合度水平比较一般;VCG与金标准存在一致性(Kappa=0.610,P<0.01),同样吻合度水平比较一般;CDEC与金标准没有一致性(Kappa=0.243,P>0.05)。结论 ECG对AMI有较高的诊断价值,VCG对OMI有较高的诊断价值;CDEC对室壁瘤的诊断价值较VCG和CDEC高。

Objective To investigate the diagnostic value of electrocardiogram（ ECG）,vectorcardiography（ VCG） and color doppler echocardiography（ CDEC） in patients with myocardial infarction. Methods Totally 119 patients with myocardial infarction were examined by ECG,VCG and CDEC respectively. Results Totally 81 cases of AMI,59 cases（ 72. 84%） were detected by ECG,significantly higher than 32 cases（ 39. 51%） of VCG and 9 cases（ 11. 11%） of CDEC（ χ~2= 63. 860,P 0. 001）; 38 cases of OMI,VCG examination 22 cases（ 57. 89%） were significantly higher than 9 cases（ 23. 68%） of ECG and 11 cases（ 28. 95%） of CDEC（ χ~2= 11. 083,P = 0. 004）; 5 cases of ventricular aneurysm were detected by CDEC,there was a consistency between ECG and gold standard（ Kappa = 0. 423,P〈 0. 01）,but the degree of consistency was normal; There was no consistency between CDEC and the gold standard（ Kappa = 0. 243,P 0. 05）. Conclusion ECG has higher diagnostic value for AMI,VCG has higher diagnostic value for OMI; CDEC has higher diagnostic value for ventricular aneurysm than VCG and CDEC.