心肌缺血合并左束支传导阻滞患者的分类算法验证  

Validation of classification algorithm for patients with myocardial ischemia and left bundle branch block

作　　者：陈哲民[1] 廖丽红[1] 施丽沙[1] 曾清芳 CHEN Zhemin;LIAO Lihong;SHI Lisha;ZENG Qingfang(ECG Room,No.910 Hospital of Joint Logistics Support Force of PLA,Quanzhou Fujian 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院心电图室,福建泉州362000 [2]中国人民解放军联勤保障部队第910医院卫勤处,福建泉州362000

出　　处：《中国急救复苏与灾害医学杂志》2023年第2期149-152,156,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：福建省医学创新课题项目(编号:2018-CX-42)。

摘　　要：目的分析针对心肌缺血合并左束支传导阻滞患者的新算法对心肌梗死犯罪血管的判断价值。方法回顾性分析2015年1月—2020年12月间中国人民解放军联勤保障部队第910医院收治的1897例心肌缺血患者资料,其中51名(2.69%)存在左束支传导阻滞。分别使用改良Sgarbossa标准和基于血流动力学的新算法对左束支传导阻滞患者进行分类,比较两种方法对犯罪血管的诊断效能。结果合并左束支传导阻滞患者的年龄较大,急性肺水肿、心源性休克和室速/室颤发生率较高。基于血流动力学的新算法识别罪犯病变的敏感性为100.00%,准确性为80.39%,优于改良Sgarbossa标准敏感性67.74%,准确性74.51%。结论基于血流动力学的新算法对识别心肌缺血合并左束支传导阻滞患者犯罪血管具有较高效能。Objective To analyze the value of the new algorithm for patients with myocardial ischemia and left bundle branch block the diagnosis of the criminal vessels of myocardial infarction.Methods The clinical data of 1897 patients with myocardial ischemia treated in No.910 Hospital of Joint Logistics Support Force of PLA from January 2015 to December 2020 were analyzed retrospectively,of which 51(2.69%)had left bundle branch block.The patients with left bundle branch block were classified by the modified Sgarbossa criteria and the new algorithm based on hemodynamics.The diagnostic efficacy of the two methods was compared.Results The patients with left bundle branch block were older,and the incidence of acute pulmonary edema,cardiogenic shock and ventricular tachycardia/ventricular fibrillation were higher.The new algorithm based on hemodynamics had a sensitivity of 100.00%and an accuracy of80.39%,which was better than the modified Sgarbossa criteria,with a sensitivity of 67.74%and an accuracy of74.51%.Conclusion The new algorithm based on hemodynamics is effective in identifying criminal vessels in patients with myocardial ischemia and left bundle branch block.

关 键 词：左束支传导阻滞 心肌缺血 心肌梗死 犯罪血管 鉴别诊断 

分 类 号：R541.4[医药卫生—心血管疾病]