12导联动态心电图对心绞痛稳定型与变异型分类的临床诊断价值分析

Analysis of the clinical diagnostic value of 12-lead dynamic electrocardiogram in the classification of stable and variant angina pectoris

目的 探究12导联动态心电图对心绞痛稳定型与变异型分类的临床诊断价值。方法 60例心绞痛患者,其中30例稳定型心绞痛, 30例变异型心绞痛,均实施12导联动态心电图诊断。分析60例患者12导联动态心电图检出情况、影像学特征;比较不同类型心绞痛患者12导联动态心电图诊断结果 (室性早搏、T波高耸、ST段抬高、U波倒置)、心率变异性[全部窦性心搏RR间期的标准差(SDNN)、相邻NN之差>50 ms的个数占总窦性心搏个数的百分比(PNN50)、相邻RR间期差值的均方根(rMSSD)]。结果 以冠状动脉造影诊断为金标准,使用12导联动态心电图诊断,变异型心绞痛检出28例,检出率为93.33%;稳定型心绞痛患者检出29例,检出率为96.67%。变异型心绞痛患者的U波倒置、室性早搏、T波高耸、ST段抬高发生率分别为60.00%、76.67%、93.33%、80.00%,高于稳定型心绞痛患者的30.00%、40.00%、33.33%、36.67%,差异具有统计学意义(P<0.05)。变异型心绞痛患者SDNN(83.75±14.47)ms高于稳定型心绞痛患者的(61.34±15.63)ms, PNN50(4.36±1.67)%、rMSSD(33.86±13.54)低于稳定型心绞痛患者的(6.85±1.54)%、(42.85±15.63),差异均具有统计学意义(P<0.05)。结论 心绞痛患者使用12导联动态心电图诊断能够有效鉴别变异型心绞痛、稳定型心绞痛,为疾病的对症治疗提供参考。

Objective To investigate the clinical diagnostic value of 12-lead dynamic electrocardiogram in the classification of stable and variant angina pectoris.Methods 60 patients with angina pectoris,including 30 cases of stable angina pectoris and 30 cases of variant angina pectoris,were all diagnosed by 12-lead dynamic electrocardiogram.The detection of 12-lead dynamic electrocardiogram and imaging features of 60 patients were analyzed.The results of 12-lead dynamic electrocardiogram(premature ventricular beats,high T-wave,ST-segment elevation,U-wave inversion)and heart rate variability[standard deviation of NN intervals(SDNN),percentage of differences exceeding>50 ms between adjacent normal number of intervals(PNN50),root mean square of sussessive differences(rMSSD)]were compared in patients with different types of angina pectoris.Results Taking coronary angiography as the gold standard,12-lead dynamic electrocardiogram detected 28 patients with variant angina pectoris,with a detection rate of 93.33%;29 patients with stable angina pectoris,with a detection rate of 96.67%.The incidence rates of U-wave inversion,premature ventricular beats,high T-wave,and ST segment elevation in patients with variant angina pectoris were 60.00%,76.67%,93.33%,and 80.00%,which were higher than 30.00%,40.00%,33.33%,and 36.67%in patients with stable angina pectoris,and the differences were statistically significant(P<0.05).The SDNN(83.75±14.47)ms in patients with variant angina pectoris was higher than(61.34±15.63)ms in patients with stable angina pectoris,and the PNN50(4.36±1.67)%and rMSSD(33.86±13.54)were lower than(6.85±1.54)%and(42.85±15.63)in patients with stable angina pectoris.All the differences were statistically significant(P<0.05).Conclusion The diagnosis of angina pectoris patients by 12-lead dynamic electrocardiogram can effectively identify variant angina pectoris and stable angina pectoris,and provide a reference for symptomatic treatment of the disease.