24h动态心电图与常规心电图检查对冠心病患者心肌缺血及心律失常的诊断价值分析  

Analysis of the diagnostic value of 24-h ambulatory electrocardiogram and conventional electrocardiogram in myocardial ischemia and arrhythmia in patients with coronary heart disease

作　　者：韦四菊 马月红 王颖 WEI Si-ju;MA Yue-hong;WANG Ying(Department of Functional Examination(ECG Diagnostic Room),Xinyi Hospital of Traditional Chinese Medicine,Xinyi 221400,China)

机构地区：[1]新沂市中医医院功能检查科(心电图诊断室),221400

出　　处：《中国实用医药》2025年第6期70-72,共3页China Practical Medicine

摘　　要：目的 分析两种心电图(ECG)检查对冠心病(CHD)患者心肌缺血、心律失常的诊断价值。方法 回顾性选择在本院治疗的CHD患者92例,以冠状动脉(冠脉)造影检查为金标准,比较24 h动态心电图(AECG)与常规ECG对CHD患者心肌缺血的诊断效能、心律失常检出情况及ST段异常检出情况。结果 以冠脉造影检查结果为金标准,92例患者共检出心肌缺血者78例。24 h AECG对CHD患者心肌缺血诊断的敏感度、准确度、阴性预测值分别为96.15%、94.57%、80.00%,显著高于常规ECG的75.64%、75.00%、34.48%,差异显著(P<0.05);两种检查方式对CHD患者心肌缺血诊断的特异度、阳性预测值及各类心律失常类型的检出率的差异不显著(P>0.05)。24 h AECG对CHD患者ST段抬高、ST段压低的检出率及心律失常总检出率均显著高于常规ECG,差异显著(P<0.05)。结论 24 h AECG对CHD患者心肌缺血及心律失常的检出率更高,值得推广和应用。Objective To analyze the diagnostic value of two types of electrocardiograms(ECG) in myocardial ischemia and arrhythmia in patients with coronary heart disease(CHD).Methods 92 patients with CHD treated in our hospital were retrospectively selected.Coronary angiography was used as the gold standard to compare the diagnostic efficiency,arrhythmia detection and ST segment abnormality detection of 24 h dynamic electrocardiogram(AECG) and conventional ECG in CHD patients with myocardial ischemia.Results With the results of coronary angiography as the gold standard,a total of 78 myocardial ischemia were detected in 92 patients.The sensitivity,accuracy,and negative predictive value of 24-h AECG for the diagnosis of myocardial ischemia in CHD patients were 96.15%,94.57%,and 80.00%,which were significantly higher than 75.64%,75.00%,and 34.48% of conventional ECG,and the difference was significant(P<0.05).The differences in specificity and positive predictive value for myocardial ischemia and detection rate of various types of arrhythmia in CHD patients between the two examinations were not significant(P>0.05).The detection rate of ST-segment elevation and ST-segment depression and the total detection rate of arrhythmia of 24 h AECG in CHD patients were significantly higher than those of conventional ECG,and the difference was significant(P<0.05).Conclusion 24-h AECG has a higher detection rate of myocardial ischemia and arrhythmia in CHD patients,and is worthy of promotion and application.

关 键 词：动态心电图 常规心电图 冠心病 心肌缺血 心律失常 

分 类 号：R541.4[医药卫生—心血管疾病]