房颤快速检测棒临床应用观察  

Clinical observation of the detection of atrial fibrillation by atrial fibrillation rapid test stick

作　　者：陈欣 张洁[1] 潘静薇[1] 胡伟国 沈成兴 CHEN Xin;ZHANG Jie;PAN Jingwei;HU Weiguo;SHEN Chengxing(Department of Cardiology,Shanghai Sixth People’s Hospital,School of Medicine Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院心内科,上海200233

出　　处：《上海医学》2022年第11期776-780,共5页Shanghai Medical Journal

基　　金：国家科技部重点课题(2018YFC2000802)。

摘　　要：目的研究新型房颤自动检测设备房颤检测棒(简称检测棒)的结果准确性,并简要分析影响其准确性的因素。方法纳入2020年8—10月于上海交通大学医学院附属第六人民医院进行心电图和(或)动态心电图检查的门诊和住院患者,共451例(525例次)。根据患者年龄分为<75岁(363例次)和≥75岁组(162例次);根据采集质量分为优良组(300例次)、尚可组(179例次)和不良组(46例次)。比较各组间检测结果的灵敏度、特异度、阳性检测值(PPV)、阴性检测值(NPV)和准确度。分析心律失常对检测结果的影响。结果门诊患者检测棒检测结果的NPV(100.00%)显著高于住院患者(92.67%),门诊患者与住院患者检测的灵敏度、特异度、准确度的差异均无统计学意义(P值均>0.05)。<75岁组患者检测的灵敏度、NPV和准确度均显著高于≥75岁组患者(P值均<0.05)。尚可组检测结果的特异度和PPV均显著低于优良组(P值均<0.05),不良组检测的特异度、PPV、准确度均显著低于尚可组(P值均<0.001)。等比例下传心房扑动、全程心室抑制型起搏模式、合并三度房室传导阻滞患者的检测棒结果均为阴性,灵敏度为0。结论检测棒有较高的灵敏度和特异度,是一种理想的新型房颤筛查检测设备。Objective To verify the accuracy of atrial fibrillation rapid test stick(test stick)for atrial fibrillation,and briefly analyze the factors affecting the accuracy.Methods A total of 451 outpatients and inpatients(525 cases)who received electrocardiogram and(or)holter electrocardiogram examination in the Shanghai Sixth People’s Hospital,School of Medicine Shanghai Jiao Tong University from August to October 2020 were consecutively selected in this study.The patients were divided into two groups based on their ages:<75 year group(363 cases),and≥75 year group(162 cases),and divided into excellent(300 cases),fair(179 cases)and poor(46 cases)groups according to the stick results.The sensitivity,specificity and accuracy of the detection results were compared among groups.The influence of arrhythmia on the detection results was analyzed.Results The negative predictive value in outpatients was significantly higher than that in inpatients(100.00%vs.92.67%,P<0.05).There were no significant difference in sensitivity specificity and accuracy(all P>0.05).The sensitivity,negative predictive value and accuracy of<75 year group were significantly higher than those in≥75 year group(all P<0.05).The specificity and positive prediction value of fair group were significantly lower than those of excellent group(all P<0.05).The specificity,positive prediction value and accuracy of poor group were significantly lower than those of fair group(all P<0.001).Atrial fibrillation was not detected in subjects with atrial flutter in equal proportion,full ventricular inhibited pacing mode,and combined three degree atrioventricular block.Conclusion Test stick has a high sensitivity and specificity,which makes it be an ideal atrial fibrillation screening and detection device.

关 键 词：心房颤动 自动检测 心电图 

分 类 号：R541.75[医药卫生—心血管疾病]