动态心电图在老年冠心病患者中的诊断价值

Diagnostic Value of Dynamic Electrocardiogram in Elderly Patients with Coronary Heart Disease

目的:探讨动态心电图在老年冠心病患者中的诊断价值。方法:选取2021年8月-2022年1月深圳市龙华区人民医院收治的80例冠心病患者作为研究对象,所有患者给予冠状动脉造影及动态心电图检查,观察动态心电图诊断冠心病患者心律失常及心肌缺血的价值。按照左室射血分数(LVEF)将患者分组,LVEF<35%为A组,LVEF为35%~49%为B组,比较两组QRS时限值、QRS电压值、QTc间期,以及心电图异常情况。结果:80例冠心病患者经冠状动脉造影检查确诊心肌缺血78例,经动态心电图检查确诊75例,诊断准确率为96.15%,灵敏度为98.67%。80例冠心病患者经冠状动脉造影确诊心律失常77例,经动态心电图检查确认74例,诊断准确率为96.10%,灵敏度为98.65%。A组QRS时限值及QTc间期高于B组,差异有统计学意义(P<0.05);A组QRS电压值低于B组,差异有统计学意义(P<0.05)。A组QT间期离散度异常、P波终末电势异常、左心室低电压、心室肥大、左前支阻滞、Q波异常、心房颤动、室性早搏发生率均高于B组,差异有统计学意义(P<0.05)。结论:动态心电图诊断老年冠心病患者心律失常及心肌缺血的准确率较高,不同程度冠心病患者动态心电图检查结果存在差异,可用于评估冠心病患者病情。

Objective:To investigate the diagnostic value of dynamic electrocardiogram in elderly patients with coronary heart disease.Methods:A total of 80 patients with coronary heart disease treated in Shenzhen Longhua District People’s Hospital from August 2021 to January 2022 were selected as the study subjects.All patients were given coronary angiography and dynamic electrocardiogram examination,and the diagnostic value of dynamic electrocardiogram in arrhythmia and myocardial ischemia in patients with coronary heart disease was observed.Patients were divided into groups according to left ventricular ejection fraction(LVEF),those with LVEF < 35% were recorded as Group A,and those with LVEF 35%-49% were recorded as Group B.The QRS time limit,QRS voltage value,QTc interval and electrocardiogram abnormality were compared between two groups.Results:Among the 80 patients with coronary heart disease,78 cases of myocardial ischemia were diagnosed by coronary angiography,75 cases were diagnosed accurately by dynamic electrocardiogram examination,the diagnostic accuracy was96.15%,and the sensitivity was 98.67%.Among the 80 patients with coronary heart disease,77 cases of arrhythmia were diagnosed by coronary angiography,74 cases were diagnosed accurately by dynamic electrocardiogram examination,the diagnostic accuracy was 96.10%,and the sensitivity was 98.65%.The QRS time limit and QTc interval in Group A were higher than those in Group B,and the difference was statistically significant(P<0.05).The QRS voltage level in Group A was lower than that in Group B,and the difference was statistically significant(P<0.05).The incidences of abnormal QT interval dispersion,abnormal P-wave terminal potential,left ventricular low voltage,ventricular hypertrophy,left anterior branch block,abnormal Q-wave,atrial fibrillation and premature ventricular contractions in Group A were higher than those in Group B,and the difference was statistically significant(P<0.05).Conclusion:The accuracy of dynamic electrocardiogram in the diagnosis of arrhythmia and myocardial ischemia in elderly patients with coronary heart disease is high.There are differences in dynamic electrocardiogram indexes in patients with different degrees of coronary heart disease,which can be used for the evaluation of coronary heart disease.