动态心电图ST段与QTc间期对冠心病患者心肌缺血的诊断价值分析  

Analysis of the diagnostic value of ST segment and QTc interval of dynamic electrocardiogram for myocardial ischemia in patients with coronary heart disease and myocardial ischemia

作　　者：丁雪 张怡靓 DING Xue;ZHANG Yiliang(Department of Laboratory Medicine,Beijing Armed Police Corps Hospital,Beijing,100025,China)

机构地区：[1]武警北京市总队医院医学影像科,北京100027

出　　处：《当代医学》2022年第24期11-14,共4页Contemporary Medicine

摘　　要：目的探讨动态心电图ST段、QTc间期对冠心病患者心肌缺血的诊断价值。方法选取2018年1月至2021年1月武警北京市总队医院收治的150例疑似冠心病心肌缺血患者作为研究对象,均行12导联动态心电图、冠状动脉造影检查,并根据冠状动脉造影检查结果分为研究组(阳性,n=85)与对照组(阴性,n=65)。比较两组临床资料和ST段基线时、严重压低时心电图检查结果,分析不同方法对冠心病心肌缺血的诊断价值。结果研究组男性、糖尿病患者占比均高于对照组,年龄大于对照组,差异有统计学意义(P<0.05)。ST段基线时,两组ST段、QTc间期、PR间期、QT、QRS时限、P波时限、心率比较差异无统计学意义。ST段严重压低时,研究组QTc间期、QT均高于对照组,差异有统计学意义(P<0.05);两组ST段、PR间期、QRS时限、P波时限、心率比较差异无统计学意义。ST段+QTc间期对冠心病心肌缺血的诊断灵敏度、特异度、阳性预测值、阴性预测值均高于ST段、QTc间期单一检测,差异有统计学意义(P<0.05)。结论冠心病患者发生心肌缺血与性别、年龄、糖尿病史、ST段、QTc间期等密切相关,ST段、QTc间期可作为诊断冠心心肌缺血的有效指标,且二者联合检测的诊断价值较高。Objective To investigate the diagnostic value of ST segment and QTc interval of dynamic electrocardiogram for myocardial ischemia in patients with coronary heart disease and myocardial ischemia.Methods 150 patients with suspected coronary heart disease myocardial ischemia who were admitted to the Beijing Armed Police Corps Hospital from January 2018 to January 2021 were selected as the research subjects.All of them underwent 12-lead dynamic electrocardiogram and coronary angiography,and they were divided into study group(positive,n=85)and control group(negative,n=65)according to the results of coronary angiography.The clinical data of and the results of electrocardiographic examination at baseline and severe depression of ST segment were compared between the two groups,and the diagnostic value of different methods for myocardial ischemia in coronary heart disease were compared.Results The proportion of male and diabetic patients in the study group were higher than those in the control group,and the age was greater than that in the control group,and the difference was statistically significant(P<0.05).At baseline in ST segment,there were no significant differences in ST segment,QTc interval,PR interval,QT,QRS duration,P wave duration,and heart rate between the two groups.When the ST segment was severely depressed,the QTc interval and QT in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in ST segment,PR interval,QRS duration,P wave duration and heart rate between the two groups.The diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of ST segment+QTc interval for myocardial ischemia in coronary heart disease were higher than those of ST segment and QTc interval alone,and the difference was statistically significant(P<0.05).Conclusion The occurrence of myocardial ischemia in patients with coronary heart disease was related to gender,age,diabetes history,ST segment,QTc inter

关 键 词：冠心病 心肌缺血 动态心电图ST段 QTC间期 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]