无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析
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摘要
目的通过无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析,探究动态心电图在冠状动脉疾病的诊断价值,为临床医生进一步决策提供参考依据。方法选取我院2017年6月至2018年5月收治的126例内科冠心病患者,采用回顾性研究将其分为SMI动态心电图患者63例和SMI常规心电图患者60例。收集患者的一般资料,以及冠状动脉造影结果,再分别对动态心电图和常规心电图诊断SMI效果进行敏感度、特异度、准确度分析。结果动态心电图组诊断结果显示,其真阳性值高于假阴性值,差异具有统计学意义(P<0.05)。常规心电图组SMI患者诊断结果显示,其真阳性率高于假阴性率,差异具有统计学意义(P<0.05)。另外,动态心电图组诊断敏感性显著高于常规心电图组(P<0.05),动态心电图组敏感诊断特异度显著高于常规心电图组(P<0.05),动态心电图组的敏感诊断准确度显著高于常规心电图组组(P<0.05)。结论动态心电图能够准确的检测出SMI患者体征,对评估患者的预后有极其重要的意义。
Objective To compare the dynamic electrocardiogram(DCG) and coronary CT angiography(CTA) in patients with silent myocardial ischemia(SMI), so as to investigate the clinical value of DCG and provide reference for better treatment. Methods A total of 126 patients with coronary heart disease admitted to our hospital from June 2017 to May 2018 were selected and divided into DCG group(n=63) and ECG group(n=60). The general data and the CTA results of patients were collected. Then the sensitivity, specificity and accuracy of DCG and ECG in the diagnosis of SMI were analyzed. ResultsThe true-positive value was higher than the false-negative value in both DCG group and ECG group(P<0.05). The sensitivity, specificity and accuracy of DCG in the diagnosis of SMI were higher than those of the ECG(P<0.05). Conclusion The application of DCG can accurately detect the signs of SMI patients, which is extremely important for the prognosis assessment.
Objective To compare the dynamic electrocardiogram(DCG) and coronary CT angiography(CTA) in patients with silent myocardial ischemia(SMI), so as to investigate the clinical value of DCG and provide reference for better treatment. Methods A total of 126 patients with coronary heart disease admitted to our hospital from June 2017 to May 2018 were selected and divided into DCG group(n=63) and ECG group(n=60). The general data and the CTA results of patients were collected. Then the sensitivity, specificity and accuracy of DCG and ECG in the diagnosis of SMI were analyzed. ResultsThe true-positive value was higher than the false-negative value in both DCG group and ECG group(P<0.05). The sensitivity, specificity and accuracy of DCG in the diagnosis of SMI were higher than those of the ECG(P<0.05). Conclusion The application of DCG can accurately detect the signs of SMI patients, which is extremely important for the prognosis assessment.
引文
[1]黄小莲,兰晓华.动态心电图监测冠心病无症状心肌缺血的临床价值分析[J].医学影像学杂志,2015,25(1 1):2039-2041.
[2]杨法,苏明兰,李小珠,等.12导联动态心电图在老年冠心病患者心肌缺血和心律失常诊断中的价值[J].中国医药科学,2016,6(11):172-174.
[3]代少华,陈浩刚,梁翠娟,等.动态心电图与常规心电图诊断冠心病患者无症状心肌缺血的效果比较[J].中国当代医药,2 01 6,2 3(22):37-39.
[4]李艳芳.201 3年欧洲心脏病学会稳定性冠心病及心血管病伴糖尿病指南解读[J].中华老年心脑血管病杂志,2014, 16(2):221-221.
[5]钱坤,何嫣,季敏晔,等.动态心电图对无症状性心肌缺血的诊断价值[J].现代生物医学进展,2017,17(4):668-671.
[6]吴鹏.动态心电图监测诊断冠心病临床价值探讨[J].中国卫生标准管理,2016, 7(16):59-60.
[7]卢定友,顾建华,孙维高,等. 128层螺旋CT评估冠状动脉狭窄的准确性-与传统冠状动脉造影的对照研究[J].罕少疾病杂志,2016, 23(6):23-25.
[8]高立,袁旭春,聂伟霞,等.双源CT与冠状动脉造影对照评价冠状动脉临界病变[J].中国CT和MR I杂志,2018, 16(3):53-55.
[9]王兰.动态心电图在冠心病无症状性心肌缺血诊断中的临床应用观察[J].中外医学研究,2018(3):68-69.
[1 0]雷蕾.动态心电图诊断老年心血管病高危人群心律失常及心肌缺血的价值分析[J].内科,2018(1).
[11]王立波.动态心电图在无症状心肌缺血患者检出率中的作用研究[J].中国保健营养,2017, 27(25).
[12]周芸.动态心电图在诊断冠心病患者中的临床应用及变化分析[J].中国医疗器械信息,2017,23(1 3):87-88.
[13]谷长芹,刘爱荣.心电图、MRI及心脏超声在诊断心尖肥厚型心肌病中的应用[J].中国CT和MR I杂志,2018, 16(5):81-83.
[14]何启燕.冠心病无症状性心肌缺血诊断中动态心电图的应用价值评价[J].世界最新医学信息文摘,2017(37):14-16.
[15]吴巧云,欧建英.动态心电图用于冠心病无症状性心肌缺血临床诊断的价值分析[J].当代医学,2 017,23(24):92-93.
[16]陈天昌.动态心电图与常规心电图诊断冠心病患者心肌缺血效果对比[J].养生保健指南,2017,(9).
[2]杨法,苏明兰,李小珠,等.12导联动态心电图在老年冠心病患者心肌缺血和心律失常诊断中的价值[J].中国医药科学,2016,6(11):172-174.
[3]代少华,陈浩刚,梁翠娟,等.动态心电图与常规心电图诊断冠心病患者无症状心肌缺血的效果比较[J].中国当代医药,2 01 6,2 3(22):37-39.
[4]李艳芳.201 3年欧洲心脏病学会稳定性冠心病及心血管病伴糖尿病指南解读[J].中华老年心脑血管病杂志,2014, 16(2):221-221.
[5]钱坤,何嫣,季敏晔,等.动态心电图对无症状性心肌缺血的诊断价值[J].现代生物医学进展,2017,17(4):668-671.
[6]吴鹏.动态心电图监测诊断冠心病临床价值探讨[J].中国卫生标准管理,2016, 7(16):59-60.
[7]卢定友,顾建华,孙维高,等. 128层螺旋CT评估冠状动脉狭窄的准确性-与传统冠状动脉造影的对照研究[J].罕少疾病杂志,2016, 23(6):23-25.
[8]高立,袁旭春,聂伟霞,等.双源CT与冠状动脉造影对照评价冠状动脉临界病变[J].中国CT和MR I杂志,2018, 16(3):53-55.
[9]王兰.动态心电图在冠心病无症状性心肌缺血诊断中的临床应用观察[J].中外医学研究,2018(3):68-69.
[1 0]雷蕾.动态心电图诊断老年心血管病高危人群心律失常及心肌缺血的价值分析[J].内科,2018(1).
[11]王立波.动态心电图在无症状心肌缺血患者检出率中的作用研究[J].中国保健营养,2017, 27(25).
[12]周芸.动态心电图在诊断冠心病患者中的临床应用及变化分析[J].中国医疗器械信息,2017,23(1 3):87-88.
[13]谷长芹,刘爱荣.心电图、MRI及心脏超声在诊断心尖肥厚型心肌病中的应用[J].中国CT和MR I杂志,2018, 16(5):81-83.
[14]何启燕.冠心病无症状性心肌缺血诊断中动态心电图的应用价值评价[J].世界最新医学信息文摘,2017(37):14-16.
[15]吴巧云,欧建英.动态心电图用于冠心病无症状性心肌缺血临床诊断的价值分析[J].当代医学,2 017,23(24):92-93.
[16]陈天昌.动态心电图与常规心电图诊断冠心病患者心肌缺血效果对比[J].养生保健指南,2017,(9).