心电散点图及逆向技术在阵发性房颤诊断中的临床应用

Clinical application of electrocardiogram scatter plot and reverse technology in the diagnosis of paroxysmal atrial fibrillation

目的分析心电散点图及逆向技术在阵发性房颤诊断中的临床应用。方法选取2020年10月至2021年10月本院收治的50例阵发性房颤患者作为研究对象,根据房颤的发生时长与记录时长比值将其分为高负荷量组(n=22)、中负荷量组(n=16)与低负荷量组(n=12),另选取80例阵发性房颤高风险患者,按照随机数字表法分为动态心电图组和常规心电图组,每组40例。比较不同负荷量组阵发性房颤患者心电图指标和伞形、多分布形、扇形、蘑菇形、感叹号形等各类型的分布情况及常规心电图组、动态心电图组诊断结果与阵发性房颤临床诊断结果的一致性。结果高负荷量组、中负荷量组、低负荷量组心房颤动、最小心率、最大心率、平均心率比较差异无统计学意义;房颤最长持续时间由长至短分别为高负荷量组、中负荷量组、低负荷量组(P<0.05)。高负荷量组、中负荷量组、低负荷量组伞形、多分布形、扇形、蘑菇形分布比较差异无统计学意义;3组感叹号形分布占比比较差异有统计学意义(P<0.05)。常规心电图组、动态心电图组诊断与临床诊断结果的Kappa值分别为0.624、0.869。结论心电散点图及逆向技术对阵发性房颤及其不同负荷程度的诊断筛查效果较好,有利于高危险患者的早诊断、早治疗和早康复。

Objective To study and analyze the clinical application of electrocardiogram scatter plot and reverse technique in the diagnosis of paroxysmal atrial fibrillation.Methods 50 patients with paroxysmal atrial fibrillation admitted to our hospital from October 2020 to October 2021 were selected as the research subjects,and they were divided into the high load group(n=22),the medium load group(n=16)and the low load group(n=12)according to the ratio of the occurrence duration of atrial fibrillation to the recording duration.Another 80 patients with high risk of paroxysmal atrial fibrillation were selected and randomly divided into the dynamic electrocardiogram group and the routine electrocardiogram group,with 40 cases in each group.The distribution of electrocardiogram indexes in patients with paroxysmal atrial fibrillation in different load groups was compared,including umbrella shape,multi-distribution shape,fan shape,mushroom shape and exclamation mark shape,and the consistency of diagnosis results between routine electrocardiogram group and dynamic electrocardiogram group and clinical diagnosis results of paroxysmal atrial fibrillation.Results There were no significant difference in atrial fibrillation,minimum heart rate,maximum heart rate and average heart rate between high load group,medium load group and low load group;the longest duration of atrial fibrillation from long to short was high load group,medium load group and low load group(P<0.05).There were no significant difference in the distribution of umbrella shape,multi-distribution shape,fan shape and mushroom shape among high load group,medium load group and low load group;there was significant difference in the proportion of exclamation mark distribution among three groups(P<0.05).The consistency of diagnosis and clinical diagnosis results in routine electrocardiogram group and dynamic electrocardiogram group was 0.624 and 0.869 respectively.Conclusion Electrocardiogram scatter plot and reverse technology are effective in the diagnosis and screening of paroxysmal atrial fibrillation and its different load levels,which is conducive to early diagnosis,early treatment and early rehabilitation of high-risk patients.