心电图平板运动试验在冠心病患者心肌缺血诊断中的应用  

Electrocardiographic Plate Exercise Test in the Diagnosis of Myocardial Ischemia in Patients with Coronary Heart Disease

作　　者：李朝晖[1] 杨梦婵 吕柯 Li Zhaohui;Yang Mengchan;Lu Ke(Nanyang First People’s Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市第一人民医院,河南南阳473000

出　　处：《黑龙江医学》2024年第3期286-289,共4页Heilongjiang Medical Journal

摘　　要：目的:探究12导联动态心电图(AECG)、平板运动试验(TET)应用于冠状动脉粥样硬化性心脏病(以下简称冠心病)患者心肌缺血中的诊断价值,为临床早期评估心肌缺血预后风险提供参考。方法:选取2021年5月—2022年8月南阳市第一人民医院收治的134例疑似心肌缺血的冠心病患者作为研究对象,以冠状动脉造影检查为金标准,分别进行AECG、TET检查,评估AECG、TET单独及联合检查对心肌缺血(冠脉狭窄≥50%)的诊断价值。结果:冠状动脉造影检查诊断出91例冠脉狭窄≥50%的心肌缺血患者,AECG检查+TET试验诊断出89例。AECG+TET检查诊断灵敏度、准确度及阴性预测值高于AECG、TET单独检查,漏诊率低于AECG、TET单独检查,差异有统计学意义(χ^(2)=11.107、8.795、7.546、8.795,P<0.05);根据AECG+TET检查诊断结果分为心肌缺血组、未心肌缺血组,心肌缺血组多支血管病变率高于未心肌缺血组,参考段血管径小于未心肌缺血组,直径狭窄率高于未心肌缺血组,差异有统计学意义(χ^(2)=5.909;t=2.541、3.350,P<0.05);AECG+TET检查诊断心肌缺血血管病变程度的符合率高于AECG、TET单独检查诊断,差异有统计学意义(χ^(2)=30.695,P<0.05)。结论:AECG+TET检查可有效提高冠心病患者心肌缺血诊断准确率,减少漏诊,明确血管病变程度,为临床早期针对性干预提供依据,改善患者预后。Objective:To investigate the diagnostic value of 12-lead ambulatory electrocardiogram(AECG)and platelet exercise test(TET)applied in myocardial ischemia in patients with coronary atherosclerotic heart disease(hereinafter referred to as coronary artery disease),and to provide a reference for the early assessment of the prognostic risk of myocardial ischemia in clinical practice.Methods:A total of 134 patients with coronary artery disease with suspected myocardial ischemia admitted to the hospital from May 2021 to August 2022 were selected for the study.Coronary angiography was used as the gold standard,and AECG and TET were performed separately to assess the diagnostic value of AECG and TET alone and in combination for myocardial ischemia(coronary stenosis≥50%).Results:Coronary angiography diagnosed 91 patients with coronary stenosis≥50%myocardial ischemia,and AECG examination+TET test diagnosed 89.The diagnostic sensitivity,accuracy and negative predictive value of AECG+TET examination were higher than that of AECG and TET alone,and the leakage rate was lower than that of AECG and TET alone,and the difference was statistically significant(χ^(2)=11.107,8.795,7.546,8.795,P<0.05).According to the diagnostic results of AECG+TET examination,they were divided into myocardial ischemia group and non-myocardial ischemia group.The rate of multibranch vasculopathy in the myocardial ischemia group was higher than that in the non-myocardial ischemia group,and the diameter stenosis rate of the reference segment was smaller than that of the non-myocardial ischemia group,and the rate of diameter stenosis was higher than that of the non-myocardial ischemia group,and the difference was statistically significant(χ^(2)=5.909,t=2.541,3.350,P<0.05).The compliance rate of AECG+TET examination to diagnose the degree of myocardial ischemic vasculopathy was higher than the diagnosis of AECG and TET examination alone,and the difference was statistically significant(χ^(2)=30.695,P<0.05).Conclusion:AECG+TET examination can effectively

关 键 词：心肌缺血 平板运动试验 冠状动脉粥样硬化性心脏病 12导联动态心电图 

分 类 号：R44[医药卫生—诊断学]