动态心电图对比常规心电图在无症状心肌缺血患者中的应用

Application of Dynamic Electrocardiogram and Routine Electrocardiogram in the Patients with Silent Ischemia

目的分析动态心电图对比常规心电图在无症状心肌缺血患者中的应用效果。方法方便选取2017年6月—2018年6月于该院就诊并同时进行冠状动脉造影、动态心电图及常规心电图检查的120例患者作为研究对象进行回顾性研究,观察动态心电图及常规心电图对无症状心肌缺血的检出情况。研究中无症状心肌缺血诊断"金标准"为冠脉造影检查结果,分析比较动态心电图及常规心电图的诊断敏感度、特异度、准确度及与冠脉造影检查结果的一致性。结果常规心电图诊断敏感度、特异度、准确度分别为71.79%、59.52%、67.50%,动态心电图诊断敏感度、特异度、准确度分别为85.90%、78.57%、83.33%,差异有统计学意义(χ~2=17.532、18.365、15.423,P<0.05),与冠脉造影检查结果比较,常规心电图一致性中等(Kappa=0.517),动态心电图一致性良好(Kappa=0.789),对于动态心电图发现的心肌缺血时间分布结果,发现患者出现心肌缺血表现的主要时间段为6:00-12:00,因此,在此时间段内行常规心电图检查可有效提高无症状心肌缺血的检出率。结论动态心电图在无症状心肌缺血患者中诊断效果明显优于常规心电图,值得临床广泛研究推广。

Objective To analyze the application effect of dynamic electrocardiogram and routine electrocardiogram in the patients with silent ischemia.Methods 120 cases of patients with coronary arteriongraphy for dynamic electrocardiogram and routine electrocardiogram in our hospital from June 2017 to June 2018 were conveniently selected,and the test condition of the dynamic electrocardiogram and routine electrocardiogram in the patients with silent ischemia was observed,and the coronary angiography examination results were the golden standards of silent ischemia,and the diagnosis sensitivity,specificity,accuracy and consistency with coronary angiography results were analyzed.Results The sensitivity,specificity,accuracy of routine electrocardiogram and dynamic electrocardiogram were respectively 71.79%,59.52%,67.50%and 85.90%,78.57%,83.33%,and the differences were statistically significant(χ^2=17.532,18.365,15.423,P<0.05),and the consistency of routine electrocardiogram with the coronary angiography results was moderate(Kappa=0.517),and the consistency of dynamic electrocardiogram with coronary angiography results was good(Kappa=0.789),and the major time phrase of patients with ischemia myocardial was 6:00-12:00,therefore,the routine electrocardiogram can effectively improve the test rate of silent ischemia.Conclusion The effect of dynamic electrocardiogram in diagnosis of patients with silent ischemia is better than that of routine electrocardiogram,which is worth wide study and promotion in clinic.