频谱心电图在中青年糖尿病患者无症状心肌缺血早期诊断中的应用价值  

Study on early diagnosis of silent myocardial ischemia in young and middle-aged patients with diabetes by spectral electrocardiogram

作　　者：刘亚贤 张春喻 范长青[1] 张靖 LIU Yaxian;ZHANG Chunyu;FAN changqing;ZHANG Jing(Department of Versatile Medicine,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 750002,China;Medical Education Management Office,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 750002,China;Department of General Medicine,Chongqing Ninth People’s Hospital,Chongqing 400700,China)

机构地区：[1]宁夏回族自治区人民医院<宁夏老年疾病临床医学研究中心>全科医学科,宁夏银川750002 [2]宁夏回族自治区人民医院<宁夏老年疾病临床医学研究中心>医学教育管理处,宁夏银川750002 [3]重庆市第九人民医院全科医学科,重庆400700

出　　处：《医药前沿》2023年第9期31-33,40,共4页Journal of Frontiers of Medicine

摘　　要：目的:探讨频谱心电图在中青年糖尿病患者无症状心肌缺血(SMI)早期诊断中的应用价值。方法:选取2021年1月-12月宁夏回族自治区人民医院诊断治疗的120例中青年糖尿病患者,开展频谱心电图以及动态心电图检查。以冠脉造影检查结果作为“金标准”,比较频谱心电图及动态心电图检查在中青年糖尿病患者SMI诊断中的准确率、灵敏度、特异性。分析频谱心电图、动态心电图与冠状动脉造影诊断的一致性。结果:120例糖尿病患者中,冠脉造影共检出97例SMI,23例无SMI;频谱心电图检出94例SMI,26例无SMI;动态心电图检出83例SMI,37例无SMI。频谱心电图诊断SMI的准确率、灵敏度、特异性均高于动态心电图检查,差异均有统计学意义(P<0.05)。频谱心电图与冠状动脉造影诊断比较,Kappa=0.564,一致性中等;动态心电图与冠状动脉造影诊断比较,Kappa=0.083,一致性差。结论:与动态心电图相比,频谱心电图具有更高的准确率、灵敏度、特异性,且一致性较好,应用于中青年糖尿病患者无症状心肌缺血的早期诊断具有较大的价值。Objective To study and analyze the role of spectral electrocardiogram in the diagnosis of silent myocardial ischemia(SMI)in young and middle-aged patients with diabetes.Methods A total of 120 young and middle-aged patients with diabetes diagnosed and treated in the People’s Hospital of Ningxia Hui Autonomous Region from January to December 2021 were selected as the research subjects,spectral electrocardiogram and dynamic electrocardiogram examinations were conducted.Taking the results of coronary angiography as the“gold standard”.The accuracy,sensitivity and specificity of spectral electrocardiogram and dynamic electrocardiogram in the diagnosis of SMI in young and middle-aged patients with diabetes were studied and compared,and the consistency of spectral electrocardiogram,dynamic electrocardiogram and coronary angiography were analyzed.Results In 120 patients with diabetes,coronary angiography detected 97 cases of SMI,23 cases without SMI;94 cases of SMI were detected by spectral electrocardiogram,and 26 cases without SMI;83 cases of SMI were detected by dynamic electrocardiogram,and 37 cases without SMI.The accuracy,sensitivity,and specificity of spectral electrocardiogram in diagnosing SMI were higher than those of dynamic electrocardiogram examination,and the differences were statistically significant(P<0.05).The comparison between spectral electrocardiogram and coronary angiography showed a moderate consistency with Kappa=0.564.The comparison between dynamic electrocardiogram and coronary angiography showed a poor consistency with Kappa=0.083.Conclusion Compared with dynamic electrocardiogram,spectral electrocardiogram has higher accuracy,sensitivity,specificity,and moderate consistency.It has a good role in the early diagnosis of silent myocardial ischemia in young and middle-aged patients with diabetes.

关 键 词：糖尿病无症状心肌缺血 早期诊断 频谱心电图 

分 类 号：R587.1[医药卫生—内分泌]