12导联动态心电图与常规心电图对冠心病伴发心律失常的评估价值

Evaluated value of 12-lead dynamic electrocardiogram and routine electrocardiogram on patients with coronary heart disease and arrhythmia

目的探究12导联动态心电图对冠心病患者伴发心律失常检出率及诊断效能。方法招募我院2021年4月~2023年4月139例冠心病患者纳入研究,根据是否伴发心律失常分为研究组(93例,伴发心律失常)和对照组(46例,不伴发心律失常),两组均接受12导联动态心电图、常规心电图检查。比较两组心律失常及心电异常检出率、窦性R-R期间总体标准差(SDNN),使用受试者(ROC)曲线分析SDNN诊断冠心病伴发心律失常的效能。结果研究组心律失常、室性早搏成对、室性早搏二、三联律、房性早搏二、三联律、短阵室上速检出率均高于对照组(P<0.05),两组房室传导阻滞、房性早搏、室性早搏检出率未见明显差异(P>0.05);研究组SDNN小于对照组,差异有统计学意义(P<0.05);ROC曲线显示:SDNN诊断冠心病伴发心律失常的曲线下面积(AUC)为0.639。结论12导联动态心电图可明确心电异常类型,同时记录SDNN有助于鉴别冠心病伴发心律失常,存在较高诊断效能。

Objective:To explore the detection rate of arrhythmia and diagnostic efficiency of 12-lead dynamic electrocardiogram in patients with coronary heart disease.Methods:139 patients with coronary heart disease in our hospital from April 2021 to April 2023 were enrolled in the study.According to whether arrhythmia occurred,they were divided into study group(93 cases,with arrhythmia)and control group(46 cases,without arrhythmia).Both groups received 12-lead dynamic electrocardiogram examination and routine electrocardiogram examination.The detection rates of arrhythmia and abnormal electrocardiogram and standard deviation of total normal R-R intervals(SDNN)were compared between both groups,and the efficiency of SDNN in diagnosing coronary heart disease with arrhythmia was analyzed by receiver operating characteristic(ROC)curve.Results:The detection rates of arrhythmia,paired ventricular premature beats,bigeminy and trigeminy of ventricular premature beats,bigeminy and trigeminy of atrial premature beats and short ventricular tachycardia in study group were higher than those in control group(P<0.05),but there were no significant differences in the detection rates of atrioventricular block,atrial premature beats and ventricular premature beats between the two groups(P>0.05).The SDNN was smaller in study group than that in control group(P<0.05).ROC curve showed that the area under the curve(AUC)of SDNN in diagnosing coronary heart disease with arrhythmia was 0.639.Conclusion:12-lead dynamic electrocardiogram can identify the types of electrocardiogram abnormalities,and recording SDNN is helpful to distinguish coronary heart disease with arrhythmia and has high diagnostic efficiency.