心电图复极参数诊断老年急性心肌梗死的临床价值及其与心功能的关系探讨  

Clinical Value of Electrocardiogram Repolarization Parameter in Diagnosis of Senile Acute Myocardial Infarction and Its Relationship with Cardiac Function

作　　者：刘健[1] 肖霞[1] 唐静[1] 王继成[1] 郑月元 LIU Jian;XIAO Xia;TANG Jing;WANG Jicheng;ZHENG Yueyuan(Panzhihua Group General Hospital,Panzhihua 617023,Sichuan,China)

机构地区：[1]攀钢集团总医院,四川攀枝花617023

出　　处：《中西医结合心脑血管病杂志》2021年第24期4349-4353,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：四川省科技厅科学研究基金资助项目(No.2019SZ23611)。

摘　　要：目的分析心电图复极参数诊断老年急性心肌梗死的临床价值及其与病人心功能的关系。方法选取2017年2月—2019年8月我院收治的急性心肌梗死病人82例为观察组,并选取同期因胸闷、胸痛入院行冠状动脉造影后排除急性心肌梗死病人68例为对照组,所有病人入院24 h内均完善心电图、超声心动图检查。比较两组心电图复极相关参数(胸导联与肢体导联QTc间期、QT间期、T波时间)、心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)],应用受试者工作特征(ROC)曲线分析心电图复极相关参数诊断急性心肌梗死的临床价值,采用Pearson相关性分析急性心肌梗死病人心电图复极相关参数与心功能指标的相关性。结果观察组胸导联QT间期、T波时间及肢体导联QTc间期、QT间期、T波时间均长于对照组(P<0.001)。胸导联与肢体导联QTc间期、QT间期、T波时间联合诊断急性心肌梗死的ROC曲线下面积(AUC)为0.858,大于各指标单一诊断,联合诊断的灵敏度为84.15%、特异度为75.00%、准确度为80.00%,与常规血清心肌肌钙蛋白I(cTnI)诊断比较差异无统计学意义(P>0.05)。急性心肌梗死病人胸导联与肢体导联QTc间期、QT间期、T波时间与LVESD、LVEDD呈正相关(P<0.001),与LVEF呈负相关(P<0.001)。结论急性心肌梗死病人心电图复极时间明显延长,心电图复极参数诊断急性心肌梗死具有较高的应用价值,且与病人心功能关系密切,有助于临床综合评估病情。Objective To explore clinical value of electrocardiogram repolarization parameter and its relationship with cardiac function in senile acute myocardial infarction.Methods Eighty-two patients with acute myocardial infarction were selected as the observation group,and 68 patients with acute myocardial infarction were selected as the control group after undergoing coronary angiography during the same period due to chest distress and chest pain.Electrocardiogram and echocardiogram examinations were completed within 24 h after admission.Electrocardiogram repolarization parameters(QTc interval,QT interval,and T-wave time in chest lead and limb lead),and cardiac function indexes[left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)]were compared between two groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of electrocardiogram repolarization parameters of acute myocardial infarction,and Pearson correlation was used to analyze the correlation between electrocardiogram repolarization parameters and cardiac function indexes in patients with acute myocardial infarction.Results The QT interval and T wave time of the chest lead,the QTc interval,QT interval and T wave time of the limb lead in the observation group were more than those in the control group(P<0.001).The area under ROC curve(AUC)of QTc interval,QT interval,and T-wave time of chest lead and limb lead in the acute myocardial infarction was 0.858,which was mone than that in a single diagnosis of each index.The sensitivity of the combined parameters diagnosis was 84.15%and the specificity was 75.00%.The sensitivity,specificity and accuracy of electrocardiogram repolarization related parameters in the acute myocardial infarction that in compared with that in conventional serum cardiac troponin I(cTnI)diagnosis(P>0.05).QTc interval,QT interval,and T-wave time of chest lead and limb lead were positively correlated with LVESD and LVEDD,but was negativ

关 键 词：急性心肌梗死 心电图 QTC间期 QT间期 T波时间 心功能 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]