常规心电图与动态心电图诊断无症状心肌缺血的价值  

Value of Routine Electrocardiogram and Dynamic Electrocardiogram in the Diagnosis of Asymptomatic Myocardial Ischemia

作　　者：刘曌 盛妍 赵欣 LIU Zhao;SHENG Yan;ZHAO Xin(Department of Electrocardiography,Yanzhou District People's Hospital of Jining,Jining 272100,Shandong,China)

机构地区：[1]济宁市兖州区人民医院心电图室,山东济宁272100

出　　处：《世界复合医学（中英文）》2024年第7期149-151,159,共4页World Journal of Complex Medicine

摘　　要：目的探究无症状心肌缺血利用常规心电图与动态心电图诊断的有效性。方法选取2022年6月—2023年10月济宁市兖州区人民医院收治的60例疑似无症状心肌缺血患者为研究对象,均实施常规心电图与动态心电图诊断,以冠状动脉造影为金标准,分析不同诊断方法准确度、特异度、灵敏度、阳性预测值、阴性预测值、误诊率、漏诊率、诊断符合率。结果冠状动脉造影确诊50例阳性,10例阴性。动态心电图准确度、特异度、灵敏度阳性预测值、阴性预测值高于常规心电图,误诊率、漏诊率低于常规心电图,差异有统计学意义(P均<0.05)。动态心电图对Ⅱ型无症状心肌缺血的诊断符合率为100.00%(20/20),高于常规心电图的80.00%(16/20),差异有统计学意义(χ^(2)=4.444,P<0.05);两种诊断方式对Ⅰ型、Ⅲ型无症状心肌缺血的诊断符合率比较,差异无统计学意义(P均>0.05)。结论动态心电图诊断无症状心肌缺血效果确切,可提高诊断准确度,减少误诊情况的发生。Objective To explore the effectiveness of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of asymptomatic myocardial ischemia.Methods A total of 60 patients with suspected asymptomatic myocardial ischemia admitted to Yanzhou District People,'s Hospital of Jining from June 2022 to October 2023 were selected as the research objects.All patients were diagnosed by routine electrocardiogram and dynamic electrocardiogram.Coronary angiography was used as the gold standard to analyze the accuracy,specificity,sensitivity,positive predictive value,negative predictive value,misdiagnosis rate,missed diagnosis rate and diagnostic coincidence rate of difference diagnosis methods.Results Coronary angiography confirmed 50 cases of positive,10 cases of negative.The accuracy,specificity,sensitivity positive predictive value and negative predictive value of dynamic electrocardiogram were higher than those of routine electrocardiogram,and the misdiagnosis rate and missed diagnosis rate were lower than those of routine electrocardiogram,and the differences were statistically significant(all P<0.05).The diagnostic coincidence rate in typeⅡasymptomatic myocardial ischemia of dynamic electrocardiogram was 100.00%(20/20),which was higher than that 80.00%(16/20)of routine electrocardiogram,and the difference was statistically significant(χ^(2)=4.444,P<0.05).There was no significant difference in the diagnostic coincidence rate in typeⅠand typeⅢasymptomatic myocardial ischemia of two diagnosis methods(both P>0.05).Conclusion Dynamic electrocardiogram is effective in the diagnosis of asymptomatic myocardial ischemia,which can improve the diagnostic accuracy and reduce the occurrence of misdiagnosis.

关 键 词：无症状心肌缺血 动态心电图 常规心电图 诊断价值 

分 类 号：R540.41[医药卫生—心血管疾病] R541.4[医药卫生—内科学]