动态心电图和常规心电图诊断完全性左束支阻滞合并急性心肌梗死的临床价值分析  

Analysis of the Clinical Value of Dynamic Electrocardiogram and Conventional Electrocardiogram in Diagnosing Complete Left Bundle Branch Block Combined with Acute Myocardial Infarction

作　　者：吴翠香 WU Cuixiang(Functional Department,Liangshan County People's Hospital,Jining,Shandong Province,272600 China)

机构地区：[1]山东省济宁市梁山县人民医院功能科,山东济宁272600

出　　处：《世界复合医学》2023年第9期81-83,87,共4页World Journal of Complex Medicine

摘　　要：目的探讨完全性左束支阻滞(completeness left bundle branch block,CLBBB)合并急性心肌梗死(acute myocardial infarction,AMI)采用动态心电图和常规心电图诊断的临床价值。方法选取2020年10月—2022年12月于山东省济宁市梁山县人民医院就诊的120例疑似CLBBB合并AMI患者作为研究对象。所有患者均先后行常规心电图和动态心电图检查,以CLBBB诊断标准、冠脉造影检查及心脏生物标志检测结果为准,比较常规心电图和动态心电图单一及联合检查诊断CLBBB合并AMI的价值。结果根据CLBBB合并AMI诊断标准,入组的120例疑似患者中最终确诊CLBBB合并AMI患者49例,非CLBBB合并AMI患者71例。常规心电图准确检出36例CLBBB合并AMI患者,60例非CLBBB合并AMI患者;动态心电图准确检出40例CLBBB合并AMI患者,64例非CLBBB合并AMI患者;两种检查联合准确检出44例CLBBB合并AMI患者,68例非CLBBB合并AMI患者;常规心电图和动态心电图联合检查的准确率、敏感性、特异性、阳性预测值、阴性预测值分别为93.33%、89.80%、95.77%、93.62%、93.15%,均高于两者单独检查。结论动态心电图和常规心电图检查均具有一定的CLBBB合并AMI诊断价值,但两者联合检查诊断的效能更高,为提高临床诊断价值,可适当选择两者联合检查。Objective To explore the clinical value of ambulatory electrocardiography and conventional electrocardiography in the diagnosis of complete left bundle branch block(CLBBB)combined with acute myocardial infarction(AMI).Methods 120 patients with suspected CLBBB combined with AMI who were treated in Liangshan County People's Hospital of Jining City,Shandong Province from October 2020 to December 2022 were selected as the research subjects.All participants underwent routine electrocardiogram and dynamic electrocardiogram examinations successively,and the results of CLBBB diagnostic standards,coronary angiography examination and cardiac biomarker detection shall prevail.Compared the value of single and combined examinations of conventional electrocardiogram and dynamic electrocardiogram in diagnosing CLBBB combined with AMI.Results According to the diagnostic criteria of CLBBB combined with AMI,49 cases of CLBBB combined with AMI and 71 cases of non-CLBBB combined with AMI were finally diagnosed among the 120 suspected patients enrolled.Routine electrocardiogram accurately detected 36 patients with CLBBB combined with AMI and 60 patients with non-CLBBB combined with AMI.Dynamic ECG accurately detected 40 patients with CLBBB combined with AMI and 64 patients with non-CLBBB combined with AMI.The combination of the two accurately detected 44 patients with CLBBB combined with AMI and 68 patients with non-CLBBB combined with AMI.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of the combined examination of conventional ECG and dynamic ECG were 93.33%,89.80%,95.77%,93.62%,and 93.15%respectively,which were all higher than the two examinations alone.Conclusion Both dynamic electrocardiogram and conventional electrocardiogram examination have certain diagnostic value for CLBBB combined with AMI,but the diagnostic efficiency of the two combined examinations is higher.In order to improve the clinical diagnostic value,the two combined examinations can be appropriately selected.

关 键 词：动态心电图 常规心电图 完全性左束支阻滞合并急性心肌梗死 诊断价值 

分 类 号：R541[医药卫生—心血管疾病]