心电散点图诊断心房纤颤伴宽QRS波的临床应用价值  

Clinical Value of ECG Scatter Chart in the Diagnosis of Atrial Fibrillation With Wide QRS Wave

作　　者：张冲冲 Zhang Chongchong(Zhengzhou second people's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院,河南郑州450000

出　　处：《哈尔滨医药》2022年第2期90-92,共3页Harbin Medical Journal

摘　　要：目的探讨心电散点图诊断心房纤颤伴宽QRS波的临床应用价值。方法对86例心房纤颤伴宽QRS波患者的临床资料进行回顾性分析,所有患者均接受动态心电图检查,并根据动态心电图结果绘制心电散点图,以经食管超声心动图为“金标准”,分析心电散点图诊断心房纤颤伴宽QRS波的临床应用价值,并比较不同类型心房纤颤伴宽QRS波的B线斜率。结果86例心房纤颤伴宽QRS波患者经“金标准”判断为室内差异性传导44例,室性期前收缩34例,室性逸博8例;心电散点图对心房纤颤伴宽QRS波诊断的总准确度为95.34%,心电散点图对室内差异性传导、室性期前收缩、室性逸博诊断的准确度分别为98.84%、95.35%、96.51%,特异度分别为100.00%、96.15%、97.44%,灵敏度分别为97.73%、94.12%、87.50%,与经食管超声心动图的一致性好(Kappa值=0.976、0.903、0.804);室内差异性传导、室性期前收缩、室性逸博B线斜率比较,差异有统计学意义(P<0.05)。结论心电散点图在心房纤颤伴宽QRS波的诊断中发挥着积极作用,能提高不同类型心房纤颤伴宽QRS波的诊断准确度,临床可将其作为诊断心房纤颤伴宽QRS波的检查手段。Objective To investigate the clinical value of ECG scatter chart in the diagnosis of atrial fibrillation with wide QRS.Methods 86 cases of patients with atrial fibrillation with wide QRS wave clinical data were retrospectively analysed,all patients were examined by dynamic electrocardiogram(ecg),and drawing according to the Results of the dynamic electrocardiogram ecg scatterplot,to as the"gold standard",transesophageal echocardiography(ecg)scatterplot diagnosis analysis atrial fibrillation with wide clinical application value of QRS wave,and compare different types of atrial fibrillation with wide QRS wave B line slope.Results Among the 86 patients with atrial fibrillation with wide QRS wave,44 cases(51.16%)were classified as indoor differential conduction,34 cases(39.53%)as ventricular prephase contraction,and 8 cases(9.30%)as ventricular extravasation.Ecg scatterplot of atrial fibrillation with wide QRS wave the total accuracy of diagnosis was 95.34%(82/86),ecg scatterplot to indoor difference conduction,contracts before sexual period,ventricular escape bo diagnosis accuracy is 98.84%,95.35%and 96.51%respectively,specific degree 100.00%,96.15%and 97.44%,respectively,sensitivity of 97.73%,94.12% and 87.50% respectively,and the consisten cy of transesophageal echocardiography(tee)good(Kappa value=0.976,0.903,0.804);There were statistically significant differences in indoor differential conduction,ventricular prephase contraction and the slope of B-line of ventricular escape wave(P<0.05).Conclusion ECG scatter map plays an active role in the diagnosis of atrial fibrillation with wide QRS,and can improve the diagnostic accuracy of different types of atrial fibrillation with wide QRS.It can be used as a diagnostic means of atrial fibrillation with wide QRS clinically.

关 键 词：心电散点图 心房纤颤 宽QRS波 动态心电图 B线斜率 

分 类 号：R541.75[医药卫生—心血管疾病]