斯克兰顿肺动脉高压心电图积分系统在急诊室内肺动脉高压诊断中的应用价值  

Application value of Scranton electrocardiogram score system in the diagnosis of pulmonary artery hypertension in emergency

作　　者：陈辉[1] 权薇[1] 郝蓬[1] 

机构地区：[1]首都医科大学附属北京安贞医院心电图室,100029

出　　处：《中国医药》2017年第2期195-198,共4页China Medicine

摘　　要：目的探讨斯克兰顿肺动脉高压（SPH）心电图积分系统对急诊室内怀疑肺动脉高压患者的快速诊断价值。方法连续选取2013年4月至2015年3月在首都医科大学附属北京安贞医院急诊科就诊、临床怀疑肺动脉高压患者93例，均进行床旁12导联体表心电图检查，并根据SPH心电图积分系统进行初步诊断，随后接受超声心动图检查进一步明确肺动脉高压诊断，比对了解前者的诊断能力。结果根据SPH心电图积分系统40例患者初步诊断为肺动脉高压，其中36例随后被心脏超声心动图检查确诊；而53例SPH心电图积分系统未诊断肺动脉高压患者中6例随后被心脏超声心动图检查确诊。以超声心动图检查结果为参照标准，采用SPH心电图积分系统进行肺动脉高压诊断的敏感度为85．7％，特异度为92．2％，假阳性率为7．8％，假阴性率为14．3％，阳性似然比为10．93，阴性似然比为0．16。结论急诊室内采用SPH心电图积分系统有助于迅速识别肺动脉高压患者。Objective To explore the value of Scranton electrocardiogram score system in rapid diagnosis and screening of pulmonary artery hypertension （PAH） in emergency. Methods Totally 93 patients with PAH from April 2013 to March 2015 in Emergency Department of Beijing Anzhen Hospital, Capital Medical University were consistently enrolled. All patients had routine 12-lead surface electrocardiogram test and scores based on Scranton electrocardiogram score system were calculated for primary diagnosis. Ultrasound cardiogram was performed to confirm diagnosis. The diagnostic accuracy of Scranton electrocardiogram score system was analyzed. Results In present study, 40 patients were primarily diagnosed of PAH based on Scanton system; 36 patients were confirmed by ultrasound cardiogram; PAH was diagnosed in other 6 patients. With results of ultrasound cardi- ogram as the reference, diagnostic sensitivity and specificity for PAH of Scanton system were 85.7% and 92. 2% , false positive rate, false negative rate, positive likelihood ratio and negative likelihood ratio were 7.8% , 14.3 %, 10.93 and 0.16, respectively. Conclusion Scanton electrocardiogram score system can rapidly screen PAH in emergency.

关 键 词：高血压  肺性 急诊处理 心电描记术 超声心动图 诊断 

分 类 号：R543.2[医药卫生—心血管疾病]