心脏彩超联合心电图诊断风湿性心脏瓣膜病的价值分析

Value Analysis of Color Doppler Ultrasound Combined with Electrocardiogram in Diagnosis of Rheumatic Heart Valvular Disease

目的:探究心脏彩超联合心电图诊断风湿性心脏瓣膜病(RHD)的价值。方法:选取2020年3月—2023年2月在本院就诊的RHD疑似患者72例,均行心脏彩超及心电图检查,以CR胸片诊断结果为金标准,观察并对比两种检查手段单独及联合对RHD的检出情况。结果:CR胸片示,RHD65例(90.28%),其他疾病7例(9.72%);心电图异常51例(70.83%),其中以传导阻滞病变占比最高,为19.44%,其次分别为心室肥大和心房肥大,分别占比16.67%和16.67%;与CR胸片结果对比,心电图对RHD诊断的灵敏度、特异度以及准确率分别为70.77%(46/65)、28.57%(2/7)和66.67%(48/72)。72例患者行心脏彩超检查,均发现有不同程度的房室扩大,其中以二尖瓣反流最为多见,其占比为44.44%;与CR胸片结果对比,心脏彩超对风湿性心脏瓣膜病诊断的灵敏度、特异度以及准确率分别为83.08%(54/65)、42.86%(3/7)和79.17(57/72)%。与CR胸片检查结果对比,心脏彩超联合心电图对RHD诊断的灵敏度、特异度以及准确率分别为90.77%、42.86%和86.11%,其均高于单独检查(P<0.05)。结论:在RHD的诊断中应用心脏彩超联合心电图检查,可有效提高临床诊断的准确率,有利于指导临床后续疾患的相关治疗,促进其预后。

Objective:To explore the value of color Doppler ultrasound combined with electrocardiogram in the diagnosis of rheumatic valvular heart disease(RHD).Methods:A total of 72 patients with suspected RHD who were treated in our hospital from March 2020 to February 2023 were selected to undergo cardiac color Doppler ultrasound and electrocardiogram.The diagnostic results of CR chest radiography were used as the gold standard.The detection of RHD by the two methods alone and in combination was observed and compared.Results:CR chest radiographs showed 65 cases of RHDD(90.28%)and 7 cases of other diseases(9.72%).There were 51 cases(70.83%)with abnormal electrocardiogram,among which the highest proportion was conduction block(19.44%),followed by ventricular hypertrophy and atrial hypertrophy(16.67%and 16.67%,respectively).Compared with the results of CR chest film,the sensitivity,specificity and accuracy of ECG for RHD diagnosis were 70.77%(46/65),28.57%(2/7)and 66.67%(48/72),respectively.All 72 patients were found to have atrioventricular dilatation in different degrees,and mitral regurgitation was the most common,accounting for 44.44%.Compared with the results of CR chest film,the sensitivity,specificity and accuracy of color Doppler ultrasound in the diagnosis of rheumatic valvular heart disease were 83.08%(54/65),42.86%(3/7)and 79.17%(57/72).Compared with the results of CR chest X-ray examination,the sensitivity,specificity and accuracy of heart color ultrasound combined with ECG for the diagnosis of RHD were 90.77%,42.86%and 86.11%,which were higher than that of single examination(P<0.05).Conclusion:The application of color Doppler ultrasonography combined with electrocardiogram in the diagnosis of RHD can effectively improve the accuracy of clinical diagnosis,and is conducive to guiding the related treatment of subsequent clinical diseases and promoting the prognosis.