12导联动态心电图QTc间期联合ST段预测冠心病心肌缺血发作的价值

Value of 12-lead Holter QTc interval combined with ST segment in predicting myocardial ischemic attack of coronary heart disease

目的探讨12导联动态心电图QTc间期联合ST段预测冠心病(CHD)心肌缺血发作的价值。方法选取2022年3月至2023年6月在我院就诊的100例疑似CHD心肌缺血发作患者为研究对象,患者均接受12导联动态心电图、冠状动脉造影检查,并根据冠状动脉造影检查结果将患者分为心肌缺血发作组、未发作组。以冠状动脉造影结果为金标准,比较两组患者12导联动态心电图检查结果,分析QTc间期联合ST段预测CHD心肌缺血发作的价值。结果100例疑似CHD心肌缺血发作患者中,冠状动脉造影检查确诊心肌缺血发作57例,未发作43例。两组患者在ST段基线时12导联动态心电图检查的各指标比较,差异无统计学(P>0.05);心肌缺血发作组的QT、QTc间期较未发作组患者高,差异具有统计学意义(P<0.05)。QTc间期联合ST段预测CHD心肌缺血发作的准确度、灵敏度、特异度高于二者单独检测(均P<0.05)。结论12导联动态心电图QTc间期联合ST段预测CHD心肌缺血发作的价值较高,可为该病的诊疗提供参考。

Objective To investigate the value of 12-lead Holter QTc interval combined with ST segment in predicting myocardial ischemic attack of coronary heart disease(CHD).Methods 100 patients with suspected CHD myocardial ischemic attack treated in our hospital from March 2022 to June 2023 were selected as the study objects.All patients received 12-lead Holter electrocardiography and coronary angiography,and were divided into myocardial ischemic attack group and non-ischemic attack group according to the results of coronary angiography.Using the results of coronary angiography as the gold standard,the 12-lead Holter ECG of the two groups was compared to analyze the value of QTc interval combined with ST segment in predicting myocardial ischemic attack of CHD.Results Of 100 patients with suspected CHD myocardial ischemic attack,coronary angiography confirmed myocardial ischemia in 57 cases,43 cases did not attack.There was no significant difference in 12-lead holter ECG between 2 groups at baseline(P>0.05).The QT and QTc interval in myocardial ischemic attack group was higher than that in non-ischemic attack group,and the difference was statistically significant(P<0.05).The accuracy,sensitivity and specificity of QTc interphase combined with ST segment in predicting CHD myocardial ischemic attack were higher than those of QTc interphase combined with ST segment alone(both P<0.05).Conclusion 12-lead Holter QTc interval combined with ST segment has high value in predicting myocardial ischemic attack of CHD,which can provide reference for diagnosis and treatment of CHD.