超声心动图联合心电图诊断扩张型心肌病研究  

Applied research of echocardiography combined with electrocardiogram in the diagnosis of DCM

作　　者：钟婷婷 李健[2] 余兰[3] 田妍 ZHONG Ting-ting;LI Jian;YU Lan(Electrocardiogram Room,Zigong First People's Hospital,Zigong 643000,China;不详)

机构地区：[1]自贡市第一人民医院心电图室,四川自贡643000 [2]自贡市第一人民医院内分泌科,四川自贡643000 [3]自贡市第一人民医院超声科,四川自贡643000

出　　处：《中国医学装备》2022年第1期88-91,共4页China Medical Equipment

基　　金：四川省卫生和计划生育委员会科研课题(16P1599)“超声心动图检查诊断扩张型心肌病的应用效果观察”。

摘　　要：目的:探讨超声心动图联合心电图在扩张型心肌病(DCM)诊断中的应用。方法:选取医院收治的108例DCM患者的临床资料,根据美国纽约心脏病学会心功能分级(NYHA)将其分为Ⅱ级组(45例)、Ⅲ级组(38例)和Ⅳ级组(25例)。比较3组患者超声心动图检查的左室舒张末期内径(LVEDd)、右室舒张末期内径(RVEDd)和左室射血分数(LVEF),以及心电图的心室肌除极的电位变化QRS群波、QT间期离散度(QTd)值。采用受试者工作特征(ROC)曲线下面积(AUC),分析3组超声心动图和心电图对DCM预测效能。采用Spearman相关性分析LVEDd、RVEDd、LVEF与QRS、QTd及心律失常发生率的相关性。结果:Ⅳ级组超声心动图LVEDd、RVEDd高于Ⅲ级组和Ⅱ级组,LVEF低于Ⅲ级组和Ⅱ级组,差异有统计学意义(F=25.441,F=7.091,F=105.837;P<0.05);Ⅳ级组心电图QRS波群、QTd均高于Ⅲ级组和Ⅱ级组Ⅳ级组,差异有统计学意义(F=20.879,F=17.815;P<0.05)。LVEDd、RVEDd、LVEF、QRS及QTd联合检测DCM的AUC为0.874,95%CI为0.769~0.978,灵敏度和特异度分别为96.00%和88.00%,均高于单独检测的各项指标。QRS、QTd与LVEDd、RVEDd呈正相关性(r_(QRS)=0.367,r=0.371;r_(QTd)=0.380,r=0.401;P<0.05),与LVEF呈负相关(r=-0.348,r=-0.355;P<0.05)。结论:超声心动图联合心电图可提高DCM诊断率,且具有较高的应用价值。Objective:To explore the application of echocardiography combined with electrocardiogram in the diagnosis of dilated cardiomyopathy(DCM).Methods:The clinical data of 108 patients with DCM who admitted to hospital were collected.According to the cardiac functional grading of New York Heart Association(NYHA),the patients were divided into grade Ⅱ group(n=45),grade Ⅲ group(n=38)and gradeⅣgroup(n=25).The left ventricular end diastolic diameter(LVEDd),right ventricular end diastolic diameter(RVEDd),left ventricular ejection fraction(LVEF)of echocardiography,and the QRS wave group of the potential change post depolarization and the dispersion value in QT interval(QTd)on ventricular muscle of electrocardiogram among three groups were compared.The area under curve(AUC)of receiver operating characteristic(ROC)was adopted to analyze the forecast performances of echocardiography and electrocardiogram on three groups.Spearman correlation was adopted to analyze the correlations among LVEDd,RVEDd,LVEF and QRS,QTd and the incidence of arrhythmia.Results:The LVEDd and RVEDd of echocardiography in grade Ⅳ group were significantly higher than those in grade Ⅲ and grade Ⅱ group,and the LVEF of grade Ⅳ group was significantly lower than that of grade Ⅲ and Ⅱ group(F=25.441,F=7.091,F=105.837,P<0.05).The QRS wave group and QTd of electrocardiogram of grade Ⅳ group were significantly higher those of grade Ⅲ group and grade Ⅱ group(F=20.879,F=17.815,P<0.05),respectively.The AUC of the combined detection of LVEDd,RVEDd,LVEF,QRS and QTd to DCM was 0.874,with 95%CI(0.769-0.978).And the sensitivity and specificity of the combined detection were 96.00% and 88.00%,respectively,which were higher than each indicator of single detection.And QRS and QTd were positive correlation with LVEDd and RVEDd(r_(QRS)=0.367,r=0.371,r_(QTd)=0.380,r=0.401,P<0.05),respectively,and they were negative correlation with LVEF(r=-0.348,r=-0.335,P<0.05).Conclusion:Echocardiography combined with electrocardiogram can improve the diagnosis rate

关 键 词：扩张型心肌病(DCM) 超声心动图 心电图 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]