食管电生理检查在鉴别宽QRS波心动过速中的诊断价值  

Differential diagnosis value of different algorithms in wide QRS complex tachycardia

作　　者：郭丽娟[1] 

机构地区：[1]河北省衡水市哈励逊国际和平医院心内科,衡水053000

出　　处：《陕西医学杂志》2017年第8期1043-1045,共3页Shaanxi Medical Journal

摘　　要：目的:分析食管电生理检查在宽QRS波心动过速(WCT)中的诊断临床价值。方法:对WCT患者采用DF-5A型电生理剌激仪实施食管电生理检查,并分别采用3种ECG检测标准:Brugada四步法、aVR导联四步法、RWPT法对WCT进行检测,分析四种方法诊断的准确率,对VT的敏感性和特异性。结果:84例WCT患者中,VT 47例,SVT 37例;应用Brugada四步法正确诊断率85.7%;aVR导联四步法,正确诊断率69.0%;RWPT法正确诊断率为63.1%,食管电生理检查正确诊断率为98.8%;Brugada 4步法、aVR单导联法、RWPT法、食管电生理检查法的VT敏感性分别为82.9%、80.9%、38.2%、97.8%;Brugada 4步法、aVR单导联法、RWPT法、食管电生理检查法的VT特异性分别为86.8%、60.6%、79.5%、100%;Brugada 4步法、aVR单导联法、RWPT法、食管电生理检查法的准确率、敏感性、特异性差异有显著统计学意义(P<0.05)。结论:食管电生理检查鉴别宽QRS波心动过速,诊断效果好,准确性高。Objective：To compare and analyze the clinical value of esophageal electrophysiological examination in the diagnosis of wide QRS complex tachycardia （WCT）.Methods：WBC patients with cardiac surgery and emergency department were treated with DF-5A electrophysiological stimulator to perform esophageal electrophysiological examination.Three kinds of ECG test criteria were used： Brugada four-step method,aVR lead four-step method ,RWPT method to detect WCT,analysis of four methods to determine the accuracy of the VT sensitivity and specificity.Results：84 cases of WCT patients,VT 47 cases,37 cases of SVT;84 cases of WCT patients,VT 47 cases,37 cases of SVT;application of Brugada four-step diagnostic accuracy of 85.7%;aVR lead four-step method,the correct diagnosis rate of 69.0%;RWPT method of the correct diagnosis rate of 63.1%,esophageal electrophysiology Check the correct diagnosis rate of 98.8%;Brugada 4 step method,aVR single lead method,RWPT method and esophageal electrophysiological examination of VT sensitive were 82.9%、80.9%、38.2%、97.8%;which the VT specificity were 86.8%,60.6%,79.5%,100%.The accuracy,sensitivity and specificity of Brugada 4-step method,aVR single-lead method,RWPT method and esophageal electrophysiological examination were significant （P〈0.05）.Conclusion： The esophageal electrophysiological examination to identify wide QRS complex tachycardia,the diagnosis is good,high accuracy.

关 键 词：心动过速/诊断 食管电生理检查 

分 类 号：R541.71[医药卫生—心血管疾病]