便携式掌式12导联心电信号采集装置在老年心血管疾病中的诊断效能  

Diagnostic efficiency of portable handheld 12-lead ECG signal acquisition device in elderly patients with cardiovascular diseases

作　　者：芦婷婷 曹瑞华 王雨嘉 申玉玉 李颖苇 高姗 孙广华 王慧泉[3] 范利 曹丰 Lu Tingting;Cao Ruihua;Wang Yujia;Shen Yuyu;Li Yingwei;Gao Shan;Sun Guanghua;Wang Huiquan;Fan Li;Cao Feng(Department of Cardiology,Second Medical Centre of Chinese PLA General Hospital,National Clinical Research Centre for Geriatric Diseases,Beijing 100853,China;Department of Clinical Medicine,School of Medicine,Nankai University,Tianjin 300071,China;School of Life Sciences,Tiangong University,Tianjin 300387,China)

机构地区：[1]中国人民解放军总医院第二医学中心心血管内科,国家老年疾病临床医学研究中心,北京100853 [2]南开大学医学院临床医学系,天津300071 [3]天津工业大学生命科学学院,天津300387

出　　处：《中华老年多器官疾病杂志》2023年第11期842-846,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(92249301);卫健委重点课题(2020ZD05);科技部重点研发计划(2022YFC3602400)。

摘　　要：目的探讨便携式掌式12导联心电信号采集装置(PH-ECG)在老年心血管病患者中的诊断效能。方法选择2020年2月至2022年12月就诊于中国人民解放军总医院第二医学中心血管内科,明确诊断心肌梗死、房颤(AF)等不同心血管疾病的315例门诊和住院老年患者为研究对象,对患者分别进行标准12导联心电图(CL-ECG)及PH-ECG检查,统计PH-ECG在不同心血管疾病诊断中的灵敏度、特异度、阳性预测值(PPV)及阴性预测值(NPV)。采用SPSS 26.0统计软件进行数据分析。计数资料组间比较采用χ^(2)检验。检查结果一致性使用Kappa和配对χ^(2)检验进行评估。结果PH-ECG检测ST段改变的灵敏度、特异度及准确度分别为75.0%、98.6%及97.1%,与CL-ECG结果进行一致性检验,Kappa值为0.754,P=0.000;PH-ECG检测T波异常的灵敏度、特异度及准确度分别为75.0%、97.9%及95.6%,与CL-ECG结果进行一致性检验,Kappa值为0.750,P=0.000;PH-ECG检测房颤的灵敏度、特异度及准确度分别为95.5%、99.1%及98.1%,与CL-ECG结果进行一致性检验,Kappa值为0.949,P=0.000;PH-ECG对心肌梗死、室性早搏等其他心血管疾病诊断的灵敏度及特异度均在90%以上,与CL-ECG结果进行一致性检验,具有较好的一致性(Kappa值>0.800)。结论PH-ECG具有便携性、实时性、操作简便等优点,在院外心电图检查中具有重要前景。Objective To investigate the diagnostic efficiency of portable handheld 12-lead electrocardiogram signal acquisition device(PH-ECG)in elderly patients with cardiovascular diseases.Methods A total of 315 elderly outpatients and inpatients diagnosed with cardiovascular diseases such as myocardial infarction and atrial fibrillation(AF)in the Department of Cardiology,Second Medical Center of Chinese PLA General Hospital from February 2020 to December 2022 were recruited in this study.All of them received conventional 12-lead electrocardiography(CL-ECG)and PH-ECG respectively.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of PH-ECG with different cardiovascular diseases were calculated.SPSS statistics 26.0 was used to perform the statistical analysis.Chi-square test was employed for intergroup comparison on enumerate data.The consistency of obtained results was tested by Kappa and paired Chi-square test.Results The sensitivity,specificity and accuracy of PH-ECG in detecting ST segment changes were 75.0%,98.6%and 97.1%,respectively,and the Kappa value was 0.754,P=0.000 for consistency when compared with CL-ECG.In detecting abnormal T wave,the sensitivity,specificity and accuracy were 75.0%,97.9%and 95.6%respectively in PH-ECG,and the Kappa value was 0.750 when compared with CL-ECG.For detecting atrial fibrillation,the sensitivity,specificity and accuracy were 95.5%,99.1%and 98.1%respectively,and the Kappa value was 0.949,P=0.000.The sensitivity and specificity for the detection of myocardial infarction,premature ventricular contraction and other cardiovascular diseases were all above 90%,and there was good consistency(Kappa values>0.800)between PH-ECG and CL-ECG.Conclusion PH-ECG has the advantages of portability,real-time performance and easy operation,and has an important prospect in out-of-hospital electrocardiogram examination.

关 键 词：老年人 12导联心电图 可穿戴设备 便携式 

分 类 号：R445.9[医药卫生—影像医学与核医学]