冠心病心律失常患者应用动态心电图诊断的临床准确性及科学性分析

Clinical Accuracy and Scientific Analysis of the Application of Holter in the Diagnosis of Coronary Heart Disease and Arrhythmia

目的分析冠心病心律失常(CHDA)患者应用动态心电图(DCG)诊断的临床准确性及科学性。方法该研究对象为方便选取2018年10月—2020年1月间来院治疗的126例CHDA患者。以入院顺序为基准,A组64例行DCG诊断,B组62例行常规心电图(ECG)诊断,对比心率失常检出率与诊断精准度。结果 A组的房性早搏二/三联律检出率为34.38%,B组为17.74%,差异有统计学意义(χ^(2)=4.507,P=0.034);A组的短阵室上速检出率为21.88%,B组为8.06%,差异有统计学意义(χ^(2)=4.691,P=0.030);A组的房性早搏早发(房早早发)检出率为51.56%,B组为50.00%,差异有统计学意义(χ^(2)=0.031,P=0.861);A组的室性早搏早发(室早早发)检出率为56.25%,B组为53.23%,差异有统计学意义(χ^(2)=0.116,P=0.733);A组的房室传导阻滞(AVB)检出率为15.63%,B组为11.29%,差异有统计学意义(χ^(2)=0.507,P=0.477);A组的室性早搏二/三联律检出率为45.31%,B组为27.42%,差异有统计学意义(χ^(2)=4.350,P=0.037);A组的房性早搏成对(房早成对)检出率为12.50%,B组为1.61%,差异有统计学意义(χ^(2)=5.628,P=0.018);A组的室性早搏成对(室早成对)检出率为20.31%,B组为6.45%,差异有统计学意义(χ^(2)=5.184,P=0.023)。以病理诊断为标准,A组的诊断准确率为95.31%,B组为77.42%,差异有统计学意义(χ^(2)=8.639,P=0.003);A组的诊断敏感度为96.67%,B组为82.46%,差异有统计学意义(χ^(2)=6.413,P=0.011);A组的诊断特异度为75.00%,B组为20.00%,差异有统计学意义(χ^(2)=3.914,P=0.048)。结论为CHDA患者行DCG诊断的效果较佳,具有较高的准确率,且诊断优势明显。

Objective To analyze the clinical accuracy and scientificity of dynamic electrocardiogram(DCG)diagnosis in patients with coronary heart disease and arrhythmia(CHDA).Methods 126 CHDA patients who came to the hospital for treatment from October 2018 to January 2020 were conveniently selected.Based on the order of admission,64 cases in group A were diagnosed by DCG,and 62 cases in group B were diagnosed by conventional electrocardiogram(ECG),and the detection rate of arrhythmia findings and the accuracy of diagnosis were compared.Results The detection rate of two/triple atrial premature beats in group A was 34.38%,and that in group B was 17.74%,the difference was statistically significant(χ^(2)=4.507,P=0.034);the detection rate of short array supraventricular tachycardia in group A was 21.88%,and that in group B was 8.06%,the difference was statistically significant(χ^(2)=4.691,P=0.030);the detection rate of premature atrial contractions in group A(abbreviated as premature atrial contractions)was 51.56%,and that in group B was 50.00%,the difference was statistically significant(χ^(2)=0.031,P=0.861);the detection rate of premature ventricular contractions in group A(abbreviated as ventricular early onset)was 56.25%,and that in group B was 53.23%,the difference was statistically significant(χ^(2)=0.116,P=0.733);atrioventricular block(AVB)was detected in group A of 15.63%,group B was 11.29%,the difference was statistically significant(χ^(2)=0.507,P=0.477);the detection rate of ventricular premature beats in group A was 45.31%,and that in group B was 27.42%,the difference was statistically significant(χ^(2)=4.350,P=0.037);the detection rate of atrial premature contractions in group A(referred to as premature atrial contractions for short)was 12.50%,and that in group B was 1.61%,the difference was statistically significant(χ^(2)=5.628,P=0.018);early pairing detection rate in group A was 20.31%,and that in group B was 6.45%,the difference was statistically significant(χ^(2)=5.184,P=0.023).Taking pathological diagnosis as the standard,the diagnostic accuracy of group A was 95.31%,group B was 77.42%,the difference was statistically significant(χ^(2)=8.639,P=0.003);the diagnostic sensitivity of group A was 96.67%,and the diagnostic sensitivity of group B was 82.46%,the difference was statistically significant(χ^(2)=6.413,P=0.011);the diagnostic specificity of group A was 75.00%,and that of group B was 20.00%,the difference was statistically significant(χ^(2)=3.914,P=0.048).Conclusion The diagnosis effect of DCG for CHDA patients is better,with higher accuracy rate,and obvious advantages in diagnosis.