ST-T段改变患者心电瀑布图形态特征及其对心血管疾病的预测价值  

Morphological characteristics of electrocardiographic waterfall and its predictive value in patients with cardiovascular disease

作　　者：王芬 蔺军芳 张录兴 王文龙 张荣 WANG Fen;LIN Junfang;ZHANG Luxing;WANG Wenlong;ZHANG Rong(ECG Examination Center,Xi'an International Medical Center Hospital,Xi'an,Shaanxi 710010,China)

机构地区：[1]陕西省西安国际医学中心医院心电检查中心,陕西西安710010

出　　处：《检验医学与临床》2024年第3期346-349,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨究ST-T段改变患者心电瀑布图形态特征及其对心血管疾病的预测价值。方法选择2020年6月1日至2022年6月1日在该院进行心电瀑布图及传统心电图检查的疑似心脏病患者970例作为研究对象,根据24 h动态心电图分为ST-T段改变216例及正常心电图754例。分析心电图ST段下降、ST段抬高、T波低平、T波负向、T波正向、T波双向波长中心电瀑布图形态特征;采用一致性检验法检测心电瀑布图、常规心电图与24 h动态心电图诊断ST-T段改变的一致性;采用四格表法检测心电瀑布图、常规心电图诊断ST-T段改变的灵敏度、特异度。结果正常心电图受检者心电图波及波群TP带、P峰带、PR峰、QPS带、ST带、T峰带、TP带心电瀑布图特征主要表现浅蓝色、亮蓝色、蓝色、红色/黄色/橙色、蓝色、蓝色/亮蓝色、浅蓝色。216例ST-T段改变患者中,156例患者心电图显示为ST段下降,其中68例患者为T波负向,心电瀑布图表现为深蓝色62例(91.18%)、蓝黑色6例(8.82%);73例患者为T波正向,心电瀑布图表现为蓝黑色66例(90.41%)、深蓝色7例(9.59%)。60例患者心电图显示为ST段抬高,其中51例患者为T波正向,心电瀑布图表现为亮蓝色43例(84.31%)、深蓝色6例(11.76%)、淡黄色2例(3.92%)。74例患者存在T波负向,心电瀑布图表现为蓝黑色;124例患者存在T波正向,心电瀑布图随T波幅度呈浅蓝-亮蓝-黄-红改变;12例存在T波低平,心电瀑布图上方随T波幅度呈浅蓝-亮蓝-黄-红改变,下方主要表现为蓝黑色。心电瀑布图诊断ST-T段改变的灵敏度、特异度、准确度分别为96.30%、88.73%、90.41%,常规心电图诊断ST-T段改变的灵敏度、特异度、准确度分别为83.33%、72.68%、75.05%。一致性检验结果显示,心电瀑布图与24 h动态心电图诊断ST-T段改变的一致性极强,常规心电图与24 h动态心电图诊断ST-T段改变的一致性较好。结论ST-T改变患者心电瀑布�Objective To investigate the morphological characteristics of electrocardiogram(ECG)waterfall in patients with ST-T changes and its predictive value in patients with cardiovascular disease.Methods A total of 970 patients with suspected heart disease who both performed ECG waterfall and conventional ECG in the hospital from June 1 st 2020 to June 1 st 2022 were selected as observation subjects.216 patients with ST-T segment alteration and 754 patients with normal ECG were classified according to 24 h dynamic ECG.The morphological characteristics of ECG ST-segment decrease,ST-segment elevation,T-wave hypoplasia,T-wave negative,T-wave positive and T-wave bidirectional wavelength centered ECG waterfall were analyzed.The consistency test was used to detect the consistency of ST-T segment changes in the ECG waterfall,conventional mode and 24 h ambulatory ECG diagnosis.The sensitivity and specificity of ST-T segment changes diagnosed by ECG waterfall and conventional methods were examined by the four-frame table method.Results The waterfall features of TP band,P-peak band,PR-peak,QPS band,ST band,T-peak band,TP band ECG of normal ECG subjects with ECG wave and wave groups mainly showed light blue,bright blue,blue,red/yellow/orange,blue,blue/bright blue,light blue.Among 216 patients with ST-T segment alteration,156 patients had ST-segment drop,of which 68 patients had negative T waves,with ECG waterfall mainly showing dark blue in 62 cases(91.18%)and blue-black in 6 cases(8.82%),while 73 patients had positive T wave,with ECG waterfall showing blue-black in 66 cases(90.41%)and dark blue in 7 cases(9.59%).The ECG of 60 patients showed ST-segment elevation,of which 51 patients had positive T waves,with ECG waterfall mainly showing bright blue in 43 cases(84.31%),dark blue in 6 cases(11.76%)and light yellow in 2 cases(3.92%).74 patients had negative T waves,mainly showing blue-black;T-wave was positive in 124 patients,with light blue-bright blue-yellow-red changed with T-wave amplitude;T-wave was low in 12 patients,with ligh

关 键 词：ST-T改变 心电瀑布图 形态特征 预测价值 

分 类 号：R541.76[医药卫生—心血管疾病]