缺血性心脏病临床诊断中心电图QRS碎裂波与心电向量图T环改变的诊断价值分析  

Diagnostic value analysis of electrocardiogram QRS fragmentation wave and electrocardiogram T-ring changes in clinical diagnosis of ischemic heart disease

作　　者：王正洪 赵彭婷 朱彬[1] 游敏 WANG Zheng-hong;ZHAO Peng-ting;ZHU Bin(ECG Room,Luzhou Hospital of Traditional Chinese Medicine,Luzhou Sichuan 646000,China)

机构地区：[1]泸州市中医医院心电图室,四川泸州646000

出　　处：《临床和实验医学杂志》2023年第3期307-311,共5页Journal of Clinical and Experimental Medicine

基　　金：2018年度吴阶平医学基金会资助(编号:320.6750.17565)。

摘　　要：目的探讨在缺血性心脏病(IHD)临床诊断中心电图QRS碎裂波与心电向量图T环改变的诊断价值。方法前瞻性选取2017年1月至2019年1月泸州市中医医院收治的IHD患者134例(A组)作为研究对象,选取行健康体检的131名志愿者作为B组。诊断金标准为经皮冠状动脉造影,所有受试者均分别予以心电图QRS碎裂波与心电向量图T环改变及联合检测,分析2种检测方法的敏感度、准确性、异常检出率、T环改变率,并采用受试者工作特征(ROC)曲线比较诊断率。结果心电图碎裂QRS波、心电向量图T环改变联合诊断的敏感度为98.43%,显著高于单独诊断(84.87%、83.06%),差异有统计学意义(P<0.05)。联合诊断准确性为94.78%,显著高于心电图碎裂QRS波、心电向量图T环改变单独诊断(79.85%、79.10%),差异均有统计学意义(P<0.05)。心电图碎裂QRS波、心电向量图T环改变联合诊断的异常检出率为5.22%,显著低于单独检测(20.15%、20.90%),差异均有统计学意义(P<0.05)。A组的QRS/T值、QRS-T夹角、T环(L/W)、T环转位等的F、H、F+H、S等全部发生了T环改变,且除T环(L/W)中的F+H与B组相比无显著差异之外,其他的各T环改变率均高于B组,差异有统计学意义(P<0.05)。经ROC曲线发现,联合诊断的AUC值(0.801)显著高于心电图碎裂QRS波和心电向量图T环改变(0.703、0.657)。结论心电图QRS碎裂波与心电向量图T环改变均对IHD有较好的检测价值,联合诊断可更全面的获取IHD诊断数据,值得临床推广。Objective To investigate the diagnostic value of electrocardiogram QRS fragmentation wave and electrocardiogram T-ring changes in the clinical diagnosis of ischemic heart disease(IHD).Methods In a prospective study,134 IHD patients(group A)admitted to Luzhou Hospital of Traditional Chinese Medicine from January 2017 to January 2019 were selected as the research subjects,meanwhile,131 volunteers for physical examination were selected as group B.The gold standard for diagnosis was percutaneous coronary angiography.The ECG QRS fragmentation wave and the electrocardiogram T-ring change and combined detection were used to analyze the sensitivity,accuracy,abnormal detection rate,T-ring change rate of the two detection methods,and the receiver operating characteristic(ROC)curve was used to compare the diagnostic rate.Results The sensitivity of electrocardiogram fragmentation QRS complex and the electrocardiogram T-ring change combined diagnosis was 98.43%,which was significantly higher than that of the separate diagnosis(84.87%,83.06%),the difference was statistically significant(P<0.05).The accuracy of the electrocardiogram fragmentation QRS complex and the electrocardiogram T-ring change combined diagnostic was 94.78%,which was significantly higher than that of the separate diagnosis(79.85%,79.10%),the difference was statistically significant(P<0.05).The abnormal detection rate of the electrocardiogram fragmentation QRS complex and the electrocardiogram T-ring change combined diagnosis was 5.22%,which was significantly lower than that of the separate diagnosis(20.15%,20.90%),the difference was statistically significant(P<0.05).The QRS/T value,QRS-T angle,T-ring(L/W),F,H,F+H,S of T-ring transposition,etc.in group A all changed the T-ring,except for the T-ring(L/W).Except that there was no significant difference in F+H in W)compared with group B,the change rates of other T-rings were higher than those in group B,the differences were statistically significant(P<0.05).The ROC curve comparison showed that the AUC value of

关 键 词：心电图QRS碎裂波 心电向量图T环改变 缺血性心脏病 异常检出率 T环改变率 

分 类 号：R541[医药卫生—心血管疾病]