心电图检查用于急性心肌梗死及肺栓塞早期鉴别诊断中的临床价值  

Clinical value of electrocardiogram in early differential diagnosis of acute myocardial infarction and pulmonary embolism

作　　者：张廷训 李玉平 杜艳青 ZHANG Tingxun;LI Yuping;DU Yanqing(Department of Functional Inspection,Tengzhou Central People's Hospital,Tengzhou,Shandong,277500,China)

机构地区：[1]滕州市中心人民医院功能检查科,山东滕州277500

出　　处：《当代医学》2025年第1期112-115,共4页Contemporary Medicine

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)及肺栓塞(pulmonary embolism,PE)诊断中实施心电图检查的鉴别诊断价值。方法回顾性分析2020年8月至2022年8月滕州市中心人民医院收治的AMI患者及PE患者的临床资料,根据疾病类型分为AMI组(n=48)与PE组(n=49)。所有患者均实施心电图检查,比较两组心电图积分、异常心电图指标的检出情况。结果AMI组心电图积分低于PE组,差异有统计学意义(P<0.05);AMI组ST段抬高或压低检出率高于PE组,肺型P波、顺钟向转位、SⅠQⅢTⅢ、心电轴右偏、右束支传导阻滞检出率均低于PE组,差异有统计学意义(P<0.05);两组导联T波倒置、窦性心动过速、SⅠSⅡSⅢ检出率比较差异无统计学意义。结论AMI和PE的早期心电图特征存在明显差异,实施心电图检查可为两种疾病鉴别诊断提供可靠依据,应用价值显著。Objective To explore the differential diagnostic value of electrocardiogram in the diagnosis of acute myocardial infarction(AMI)and pulmonary embolism(PE).Methods The clinical data of patients with AMI and patients with PE admitted to Tengzhou Central People's Hospital from August 2020 to August 2022 were retrospectively analyzed,they were divided into the AMI group(n=48)and the PE group(n=49)according to the type of disease.Electrocardiogram examination was performed on all patients,and the detection of electrocardiogram scores and abnormal electrocardiogram indexes were compared between the two groups.Results The electrocardiogram score in the AMI group was lower than that in the PE group,and the difference was statistically significant(P<0.05).The detection rate of ST segment elevation or depression in the AMI group was higher than that in the PE group,the detection rates of pulmonary P wave,clockwise transposition,SⅠQⅢTⅢ,right deviation of ECG axis and right bundle branch block were lower than those in the PE group,and the differences were statistically significant(P<0.05);there was no significant difference in the detection rates of lead T wave inversion,sinus tachycardia and SⅠSⅡSⅢbetween the two groups.Conclusion There are obvious differences in early electrocardiogram characteristics between AMI and PE,electrocardiogram examination can provide reliable basis for the differential diagnosis of the two diseases,and has significant application value.

关 键 词：心电图检查 急性心肌梗死 肺栓塞 鉴别诊断 

分 类 号：R541.7[医药卫生—心血管疾病]