50步混沌强度在冠心病诊断中的价值研究  

Investigation of the clinical diagnostic value of 50-step chaometry for coronary heart disease

作　　者：赵进军[1] 刘娜[2] 罗传文[3] 王孝微[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,哈尔滨150001 [2]哈尔滨医科大学附属第四医院心血管内科,哈尔滨150001 [3]东北林业大学林学院,哈尔滨150040

出　　处：《中国实用内科杂志》2010年第6期542-543,共2页Chinese Journal of Practical Internal Medicine

基　　金：黑龙江省科技攻关项目(GB06C40301)

摘　　要：目的探索一个新的非线性检测指标在冠心病诊断中的价值。方法选取2008年3月至2009年2月哈尔滨医科大学附属第一医院住院患者,对临床表现拟诊冠心病患者在行冠状动脉造影的前一夜固定时间进行心电数据采集,剔除分析的心搏数RR间期小于90%者,最终选取124例患者为研究对象,根据冠状动脉造影结果分为冠心病组53例,中间组38例和正常组33例,3组患者均给予常规检查。所获得的RR间期数据由试验者仔细检查后盲性移交给专业人员,进行数据过滤、由50步混沌强度公式分析计算后输出。运用诊断试验方法并绘制ROC曲线进行分析。结果 3组间总体比较50步混沌强度(50SCM)差异有统计学意义(P<0.01),与对照组比较,冠心病患者的50SCM明显降低(P<0.01)。ROC曲线显示的50SCM最佳截断点是3.126,此时的敏感度为91%、特异度为82%、准确度为87%、阳性似然比5.06、阴性似然比0.1。结论冠心病患者的50SCM明显降低;50SCM为3.126时有助于诊断冠心病。Objective To evaluate the clinical diagnostic value of a new nonlinear detection of index for coronary heart disease. Methods The inpatients suspected with coronary heart disease were randomly selected from March 2008 to February 2009 in the departments of The First Affiliated Hospital of Harbin Medical University,after routine examination. The time was fixed in the night before coronary angiography for data acquisition. Those whose number of cardiac RR interval （utilization） was less than 90% were removed and eventually a total of 124 cases were selected. Basing on gold standard （coronary angiography）, the patients were divided into a group of 53 cases of coronary heart disease,middle group of 38 cases and the control group of 33 cases. In a stable state,the supine subjects were under the 12-lead ECG monitoring for 30 minutes to obtain RR interval data,and after careful examination data were blindly transferred to professionals who filtered the data, analyzed them with formula of 50- step chaometry（50SCM）and output. Finally, the date were analyzed with statistical methods. Results Between the three groups there was significant difference in 50SCM （P 〈 O. O1 ）. Compared with the control group,50SCM of CHD group was significantly reduced. The area under the ROC curve was O. 939. ROC curves showed that the best cut-off points of 50SCM was 3. 126, the sensitivity was 91%, the specificity was 82%, accuracy was 87 %, positive likelihood ratio was 5.06 and negative likelihood ratio was 0. 1. Conclusion 50SCM of CHD group is significantly reduced ;50SCM （3. 126）has significant clinical value in the diagnosis of coronary heart disease.

关 键 词：50步混沌强度 非线性分析 冠心病 

分 类 号：R5[医药卫生—内科学]