立体心电图对乳腺癌患者心肌缺血的诊断价值  

Diagnostic Value of Three-dimensional Electrocardiogram for Myocardial Ischemia in Patients with Breast Cancer

作　　者：李洁 刘玲玲 张另 LI Jie;LIU Lingling;ZHANG Ling(Department of Functional Examination,Zibo Maternal and Child Health Hospital,Zibo 255000,Shandong,China;Department of Surgery,Zibo Central Hospital,Zibo 255000,Shandong,China;Department of Surgery,Zibo Maternal and Child Health Hospital,Zibo 255000,Shandong,China)

机构地区：[1]淄博市妇幼保健院功能检查科,山东淄博255000 [2]淄博市中心医院外科,山东淄博255000 [3]淄博市妇幼保健院外科,山东淄博255000

出　　处：《世界复合医学(中英文)》2025年第1期158-161,共4页World Journal of Complex Medicine

摘　　要：目的探讨立体心电图对乳腺癌患者心肌缺血的诊断价值。方法选取2021年8月—2023年8月淄博市妇幼保健院收治的90例疑似心肌缺血的乳腺癌放化疗患者,均行常规心电图、立体心电图诊断,记录心肌缺血检出率。以冠状动脉造影(coronary angiography,ICA)测定的心肌血流储备分数(myocardial fractional flow reserve,FFR)结果为金标准,即FFR≤0.8是心肌缺血,对比常规心电图与超声心电图的诊断价值,计算诊断效能。结果90例疑似患者经ICA测定,58例确诊心肌缺血,非心肌缺血32例。常规心电图诊断心肌缺血的kappa值为0.508,立体心电图诊断心肌缺血的kappa值为0.881。立体心电图诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于常规心电图诊断,差异均有统计学意义(P均<0.05)。立体心电图对ST段抬高型心肌缺血的诊断符合率高于常规心电图,差异有统计学意义(P<0.05)。结论立体心电图可更有效检测出乳腺癌患者的心肌缺血表现,对患者具有重要意义。Objective To investigate the diagnostic value of stereocardiogram in myocardial ischemia of breast cancer patients.Methods From August 2021 to August 2023,90 patients with breast cancer suspected of myocardial ischemia treated in Zibo Maternal and Child Health Hospital were selected as the study subjects.Routine electrocardiogram and stereoscopic electrocardiogram diagnosis were performed,and the detection rate of myocardial ischemia was recorded.Myocardial fractional flow reserve(FFR)measured by Coronary angiography(ICA)is the gold standard,meaning that FFR≤0.8 is myocardial ischemia.The diagnostic value of conventional electrocardiogram and ultrasonic electrocardiogram was compared,and the diagnostic efficiency was calculated.Results Of the 90 suspected patients,58 cases were diagnosed with myocardial ischemia and 32 cases were non-myocardial ischemia.The kappa value of conventional ECG for diagnosis of myocardial ischemia was 0.508,and the kappa value of stereoscopic electrocardiogram for diagnosis of myocardial ischemia was 0.881.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of stereoscopic electrocardiogram diagnosis were higher than those of conventional electrocardiogram diagnosis,and the differences were statistically significant(all P<0.05).The diagnostic coincidence rate of stereoscopic electrocardiogram for ST segment elevation myocardial ischemia was higher than that of conventional electrocardiogram,and the difference was statistically significant(P<0.05).Conclusion Conventional electrocardiogram has a better application effect in myocardial ischemia.Compared with stereoscopic electrocardiogram,it can detect myocardial ischemia more effectively in breast cancer patients,which is of great significance for patients.

关 键 词：乳腺癌 立体心电图 常规心电图 心肌损伤 

分 类 号：R4[医药卫生—临床医学]