信号叠加心电图时域、频域多变量分析比较研究  

A COMPARATIVE STUDY ON MULTIVARIABLE ANALYSIS OF TIME AND FREQUENCY DOMAIN OF SIGNAL-AVERAGED ELECTROCARDIOGRAM

作　　者：于左 朱震[1] 张耀隆 

机构地区：[1]青岛医学院心血管病研究所

出　　处：《中国循环杂志》1992年第5期459-463,共5页Chinese Circulation Journal

摘　　要：对53例心肌梗塞(简称心梗)不伴室性心动过速(简称室速),27例心梗伴室速,42例健康者比较信号叠加心电图时域、频域多变量分析。时域:五个滤波频率以40Hz的正确率(79.71%)、特异性(88.1%)最高。频域:QRS始点后60ms延续140ms分析段(A_(60)的20～50Hz,50～80Hz的A谱面积比,20～50Hz的P谱面积比意义较大(P<0.001).正确率为85%,特异性88.68%,敏感度77.78%。LAS和A_((?)0)的20～50Hz,50～80Hz的A谱面积比为相对独立的判别参数。结果证明:频域较时域判别价值高,二者结合可提高判别效果。The value of time domain (TDA) and frequency domain analysis (FDA) of signal-averaged electrocardiogram to distinguish remote myocardial infarction (RMI) with and without sustained ventricular tachycardia (VT) was compared in 53 RMI patients without VT, 27 RMI patients with VT and 42 normal Subjects. TDA was performed with bandpass filter of 20, 25, 40, 60, 80 Hz. There was significant difference among the 3 groups at 40, 60, 80 Hz. The filter of 40 Hz was of the highest accuracy(Ac. 79.71%), specificity(Sp. 88.1%) and negative predictive value(78.93%). FDA was performed with 10 intervals of 140 ms at various points in relation to the QRS onset and offset, calculated amplitude-frequency spectra area ratio (AAR) and power-frequency spectra area ratio (PAR) of 10～50Hz, 50～80Hz, 80～120Hz. There were significant difference among 3 groups for 20～50Hz, 50～80Hz AAR and 20～50Hz PAR using the interval of starting point of 60ms after the QRS onset(A_(60) (p<0.01). FDA provided an Ac. of 85%, sensitivity (Sn) 77.78%, Sp. 88.68%. TDA and FDA were combined to distinguish RMI with and without VT, Bayes Fisher stepwise discriminant analysis showed that LAS of 40Hz and 20～50Hz, 50～80Hz AAR of A_(60) were the relative independent parameters, in which Ac. was 86.25%, Sn. 74.09%,Sp. 92.45%, positive and negative predictive value 83.3%, 87.5% respectively. Conclusion, frequency domain analysis had a better value than time domain analysis to distinguish RMI with and without VT. Combining the two methods could improve the effect of identification.

关 键 词：心肌梗塞 心动过速 心电图 

分 类 号：R542.220.4[医药卫生—心血管疾病]