心向量图结合动态心电图诊断心肌供血不足的价值研究

Study on the Value of Heart Vector Mapping Combined with Ambulatory Electrocardiogram in Diagnosing Myocardial Blood Supply Insufficiency

目的探究在心肌供血不足诊断中采取心向量图结合动态心电图的应用价值。方法选取2020年12月—2022年12月江阴市人民医院接收的疑似心肌供血不足患者80例作为研究对象,对患者进行单独动态心电图、心向量图结合动态心电图两种诊断方式,并以核素心肌灌注显像(myocardial perfusion imaging,MPI)结果作为金标准,分析诊断结果、诊断效能。结果经金标准诊断,阳性患者为74例,阴性患者为6例;经心向量图结合动态心电图诊断,真阳性患者为70例,真阴性患者为5例;经单独动态心电图诊断,真阳性患者为57例,真阴性患者为4例。采用心向量图结合动态心电图诊断的阳性检出率为88.75%、灵敏度为94.59%、阴性预测值为55.56%,诊断符合率为93.75%,均高于单独动态心电图诊断,差异有统计学意义(P<0.05)。两种诊断方式的特异度、阳性预测值相比,差异无统计学意义(P>0.05),但心向量图结合动态心电图较高。结论在诊断心肌供血不足时,采用心向量图结合动态心电图方式,具有较高诊断价值,为预后评估及处理提供重要参考。

Objective To investigate the application value of taking heart vector mapping combined with ambulatory electrocardiogram in the diagnosis of myocardial blood supply insufficiency.Methods 80 cases of suspected myocardial blood supply insufficiency received by Jiangyin People's Hospital from December 2020 to December 2022 were selected as the research subjects,and two diagnostic modes of ambulatory electrocardiogram alone and heart vector mapping combined with ambulatory electrocardiogram were carried out on the patients.The diagnostic results and diagnostic efficacy were analyzed using the results of nuclear myocardial perfusion imaging(MPI)as the gold standard.Results The 74 patients were positive and 6 patients were negative by the gold standard.After the diagnosis of heart vector mapping combined with ambulatory electrocardiography,there were 70 true positive patients and 5 true negative patients.Diagnosed by ambulatory electrocardiogram alone,57 patients were true positive and 4 patients were true negative.Analyzing the diagnostic efficacy,using heart vector mapping combined with ambulatory electrocardiogram diagnosis,the positive detection rate was 88.75%,the sensitivity was 94.59%,the negative predictive value was 55.56%,and the diagnostic compliance rate was 93.75%,higher than those of ambulatory electrocardiogram diagnosis alone,and the difference was statistically significant(P<0.05).The two diagnostic modalities in specificity and positive predictive value were compared,and the difference was not statistically significant(P>0.05),however,the heart vector mapping combined with ambulatory electrocardiogram was higher.Conclusion In the diagnosis of myocardial blood supply insufficiency,the use of heart vector mapping combined with ambulatory electrocardiogram has high diagnostic value,provides an important reference basis for prognostic assessment and treatment.