12导联动态心电图ST段联合QTc间期对冠心病心肌缺血发作的预测价值  

Predictive value of ST segment combined with QTc interval of 12-lead Holter on myocardial ischemia attack of coronary heart disease

作　　者：黄显娥 刘丽 Huang Xiane;Liu Li(Shandong Weihai Central Hospital,Weihai 264400,China)

机构地区：[1]山东省威海市中心医院,264400

出　　处：《中国实用医刊》2020年第16期86-89,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨12导联动态心电图ST段联合QTc间期对冠心病心肌缺血发作的预测价值。方法抽取威海市中心医院2018年4月至2019年6月收治的79例冠心病患者作为研究对象,对所有患者均行12导联动态心电图、冠状动脉造影检查。依据冠状动脉造影结果将79例冠心病患者分为发作组与未发作组,比较两组ST段基线时及ST段降低时心电图各项检查指标,并分析12导联动态心电图ST段、QTc间期单一检查与联合检查对心肌缺血发作的预测价值。结果经冠状动脉造影检查发现,79例冠心病患者中,心肌缺血发作34例,占43.04%,45例未发作,占56.96%。两组ST段基线时心电图各项检查指标比较,差异未见统计学意义(P>0.05);ST段严重低压时两组心率、QRS时限、ST段、P波时限、PR间期指标比较,差异未见统计学意义(P>0.05);发作组QTc间期、QT指标较未发作组高,差异有统计学意义(P<0.05);联合检查灵敏度、特异度、阳性预测值及阴性预测值均高于ST段、QTc间期单一检查,差异有统计学意义(P<0.05);ST段检查灵敏度、特异度、阳性预测值及阴性预测值与QTc间期检查比较,差异未见统计学意义(P>0.05)。结论 12导联动态心电图ST段联合QTc间期对冠心病心肌缺血发作具有较高预测价值,可为临床诊治提供重要参考。Objective To explore the predictive value of ST segment combined with QTc interval of 12-lead Holter on myocardial ischemia attack of coronary heart disease.Methods Seventy-nine patients with coronary heart disease admitted to Weihai Central Hospital from April 2018 to June 2019 were selected as the study objects.According to the results of coronary angiography,all patients were divided into attack group and non-attack group,and the indicators of electrocardiogram(EEG)at ST segment baseline and ST segment decrease in the two groups were compared,and the predictive value of 12-lead dynamic EEG at ST segment and QTc interphase single examination and combined examination on myocardial ischemic attack were analyzed.Results In 79 patients with coronary heart disease,34 had myocardial ischemia attack(43.04%,34/79),45 had no attack(56.96%,45/79).The ECG indexes between the two groups at ST segment baseline were compared,the differences were not statistically significant(P>0.05).There were no significant differences in heart rate,QRS duration,ST duration,p-wave duration and PR interval between the two groups(P>0.05).The QTc interphase and QT indexes in the attack group were higher than those in the non-attack group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of the combined test were higher than those of the single test in the ST segment and QTc interval,with statistically significant differences(P<0.05).There were no significant differences in the sensitivity,specificity,positive predictive value and negative predictive value of st-segment examination and QTc interphase examination(P>0.05).Conclusions The ST segment combined with QTc interval of 12-lead Holter has a high predictive value for myocardial ischemia attack of coronary heart disease,which can provide important reference for clinical diagnosis and treatment.

关 键 词：冠心病 心肌缺血 12导联动态心电图 ST段 QTC间期 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]