心电网络信息系统对超急性期心肌梗死诊断意义的研究

The significance of ECG network information system in the diagnosis of hyperacute myocardial infarction

目的观察心电网络信息系统对超急性期心肌梗死的诊断意义。方法选择2014年12月至2016年12月于该住院治疗的疑似超急性心肌梗死患者114例,比较传统床旁心电图(A法)和心电网络信息系统(B法)诊断超急性心肌梗死的检测报告时间和就诊费用。以心电图结合心肌酶检查结果作为最终诊断,计算两种系统诊断超急性期心肌梗死的灵敏度、特异度、准确率、阴性预测值、阳性预测。采用受试者工作特征曲线(ROC)下面积(AUC)计算两种系统对超急性期心肌梗死的诊断效能。另观察两种系统诊断2h内ST段抬高的超急性期心肌梗死患者的灵敏度、特异度和准确率、阴性预测值、阳性预测。结果 B法诊断超急性期心肌梗死检测报告时间和就诊费用均低于A法[(6.48±1.29)vs.(22.08±5.79)min;(15.39±3.75)vs.(25.40±5.53)元,t=28.101、15.994,P=0.000、0.000];B法诊断超急性期心肌梗死灵敏度、准确度及阴性预测值均高于A法(χ~2=9.280、5.004、17.351,P=0.004、0.033、0.000),且B法AUC高于A法;B法诊断2h内ST段抬高的超急性期心肌梗死的灵敏度、准确度及阳性预测值均高于A法(χ~2=10.159、5.944、6.152,P=0.002、0.020、0.018)。结论与A法相比,B法可以降低诊断超急性期心肌梗死的检测报告时间和就诊费用,提高超急性期心肌梗死和2h内ST段抬高的超急性期心肌梗死的诊断效能。

Objective To observe the significance of ECG information management system in the diagnosis of hyperacute myocardial infarction.Methods A total of 114 patients with suspected hyperacute myocardial infarction who were hospitalized from December 2014 to December 2016 were enrolled.The time and cost of diagnosis of hyperacute myocardial infarction were compared between traditional bedside ECG and ECG information management system.The results of electrocardiogram combined with myocardial enzyme test were used as the final diagnosis result.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of the two methods for diagnosis of hyperacute myocardial infarction were calculated.The diagnostic efficacy of the two methods for hyperacute myocardial infarction was calculated by using the ROC AUC.In addition,the sensitivity,specificity and accuracy,negative predictive value and positive predictive value of the two methods in the diagnosis of hyper-acute myocardial infarction with ST-segment elevation within 2 h were observed.Results The ECG report time and expenditure on diagnosing acute myocardial infarction in hyperacute phase were lower with ECG information management system than those with the bedside ECG[(6.48±1.29)min vs.(22.08±5.79)min;(15.39±3.75)yuan vs.(25.40±5.53)yuan],t=28.101,15.994,P=0.000,0.000.The sensitivity,accuracy and negative predictive value of ECG information management system in diagnosis with hyperacute myocardial infarction were higher than bedside ECG(χ2=9.280,5.004,17.351,P=0.004,0.033,0.000),and the AUC of ECG information management system was higher than bedside ECG.The sensitivity,accuracy and positive predictive value of ECG information management system in diagnosis with ST-segment elevation within 2 h was higher than bedside ECG(χ2=10.159,5.944,6.152,P=0.002,0.020,0.018).Conclusion Compared with the bedside ECG,the ECG information management system can reduce the ECG report time and expenditure in diagnose with hyper-acute myocardial infarction,and increase the diagnostic efficacy.