模糊推理在基于心电图ST-T的心肌缺血判别中的应用  

Application of Fuzzy Reasoning to Myocardial Ischemia Judgment Based on Electrocardiogram ST-T Complex

作　　者：宋晋忠[1] 严洪[1] 刘桂芝[2] 匡鸿[1] 

机构地区：[1]中国航天员科研训练中心航天医学基础与应用国家重点实验室,北京100094 [2]郑州大学第一附属医院,郑州450052

出　　处：《生物医学工程学杂志》2012年第1期147-151,156,共6页Journal of Biomedical Engineering

基　　金：中国航天医学工程预先研究项目资助(SJ201006)

摘　　要：心电图(ECG)作为检测心肌缺血的一种方便、经济、无创的工具,其临床表现主要为ST-T段改变。由于心肌缺血很多情况下是瞬时发生,并且是无症状的,此时医务人员往往无法预料而不能及时采取干预措施,若能实现计算机的自动实时监控和及时预警,在心脏疾病诊断中具有重要的意义。本文融合目前比较公认的定量判断指标,主要包括:ST段偏移量、T波峰点幅值、ST/HR值,且在医务人员的协助指导下,应用模糊推理对心肌缺血进行了判别,经MIT-BIH数据库和公共数据库(LTST)中心电数据的验证,其敏感性和阳性预测值分别达到75%和78%,特异性和阴性预测值分别达到85%和87%。该方法更接近人的思维和认识,易于临床检测和工程实现。Electrocardiogram（ECG） is a convenient,economic,and non-invasive detecting tool in myocardial ischemia（MI）.Its clinical appearance is mainly exhibited by ST-T complex change.MI events are usually instantaneous and asymptomatic in some cases,which cannot be forecasted to have a precautionary measure in time by doctors.The automatic detection of MI by computer and a cued warning of danger in real time play an important role in diagnosing heart disease.With the help of the medical staff,some quantitative approbatory indicators,such as ST-segment deviation,the amplitude of T-wave peak and the rate of ST and heart rate（HR）,were combined to judge MI using fuzzy reasoning.After MIT-BIH database and the long term ST database（LTST） verification,sensitivity and positive predictive values reached 75% and 78% respectively,and specificity and negative predictive values were 85% and 87% respectively.In addition,the proposed method was close to human way of thinking and understanding,and easy to apply in clinical detection and engineering fields.

关 键 词：心电图 ST-T段 模糊推理 心肌缺血 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]