散点图联合逆向技术诊断阵发性房颤的研究

Study on the application value of ECG scattergram combined with reverse technology in the diagnosis of paroxysmal atrial fibrillation

目的探讨心电散点图及逆向技术在阵发性房颤(PAF)诊断中的应用价值。方法回顾性分析2020年6月至2021年6月在我院确诊为PAF的50例患者的临床资料,根据发生的不同负荷量分成低负荷量组(13例)、中负荷量组(19例)、高负荷量组(18例),分别通过软件构建其Lorenz散点图、时间散点图,分析各类型各自的散点图特点及其在3组中的分布情况,结合时间散点图及逆向技术分析PAF的散点图特征,掌握其快速PAF诊断规律。再选取PAF高风险患者100例,行动态心电图和常规心电图检测,在上述诊断规律支持下,比较两组PAF检测准确性。结果低负荷组患者扇形分布最少(7.69%),感叹号形分布最多(30.77%),中、高负荷两组伞形分布最多(42.10%、38.89%),感叹号形分布最少(0%),三组在感叹号形分布比较差异具有统计学意义(χ2=11.829,P<0.05),在扇形、伞形、蘑菇形及多分布形分布比较差异不具有统计学意义(P>0.05)。临床诊断结果显示,100例PAF高风险患者确诊PAF 61例,非PAF 39例,常规心电图结果与临床诊断结果一致性为0.514,一致性一般,动态心电图检测结果与临床诊断结果一致性为0.835,一致性好,一致性比较差异具有统计学意义(Z=3.154,P=0.002)。结论Lorenz散点图结合逆向技术有助于动态心电图对PAF的快速诊断。

Objective To investigate the value of ECG scattergram and reverse technology in the diagnosis of paroxysmal atrial fibrillation(PAF).Methods The clinical data of 50 patients diagnosed as PAF in our hospital from June 2020 to June 2021 were analyzed retrospectively.The clinical data of 50 patients diagnosed as PAF in our hospital from June 2020 to June 2021 were analyzed retrospectively.According to the different loads,they were divided into low load group(13 cases),medium load group(19 cases),and high load group(18 cases).Their Lorenz scatter plots and time scatter plots were constructed by software respectively,Analyze the characteristics of each type of scatter plot and its distribution in the three groups,analyze the characteristics of the scatter plot of PAF in combination with the time scatter plot and reverse technology,and master the rule of rapid PAF diagnosis.Then 100 patients with high risk of PAF were selected,and the accuracy of PAF detection was compared between the two groups under the support of the above diagnostic rules.Results The fan shaped distribution was the least in the low load group(7.69%),the exclamation mark shaped distribution was the most(30.77%),the umbrella shaped distribution was the most in the middle and high load groups(42.10%,38.89%),and the exclamation mark shaped distribution was the least(0%).There was a statistically significant difference in the exclamation mark shaped distribution among the three groups(χ~2=11.829,P 0.05),there was no significant difference in fan,umbrella,mushroom and multi distribution(P0.05).The clinical diagnosis results showed that 61 cases of PAF and 39 cases of non PAF were diagnosed in 100 patients with high risk of PAF.The consistency between the results of conventional ECG and the clinical diagnosis was 0.514,with general consistency.The consistency between the results of dynamic ECG and the clinical diagnosis was 0.835,with good consistency.The difference in consistency was statistically significant(Z=3.154,P=0.002).Conclusions Lorenz scattergram combined with reverse technology is helpful to the rapid diagnosis of PAF by dynamic electrocardiogram.