摘要
目的:研究对比12导联动态心电图对心绞痛稳定型与变异型分类的临床诊断价值。方法:选取2015年8月至2017年8月我院收治的冠心病心绞痛患者100例为研究对象。分为稳定型心绞痛组(A组)67例,变异型心绞痛组(B组)33例。两组患者均予12导联动态心电图检查。分别比较两组患者ST段抬高、T波高耸、室性早搏以及U波倒置发生情况、心率变异性情况。并以冠状动脉造影检查结果作为金标准,分析12导联动态心电图诊断鉴别心绞痛稳定型与变异型的价值。结果:A组12导联动态心电图特点为,心绞痛发作时,心电图中以R波为主的导联上可发生水平型ST段压低>0.1 mV或延长>0.2 s,且T波呈低平或倒置。B组12导联动态心电图特点为,心绞痛发作时,心电图中Ⅱ、Ⅲ、a VF导联的ST段抬高,对应的Ⅰ、a VL导联ST段下移;V5、V6导联的ST段抬高,对应的V1、V2导联ST段下移。且在患者心绞痛环节后,心电图ST段可迅速恢复原位。A组患者ST段抬高、T波高耸、室性早搏以及U波倒置发生率均明显低于B组(P<0.05)。A组SDNN水平显著低于变异型心绞痛,而r-MSSD与PNN50水平显著高于B组(P<0.05)。12导联动态心电图诊断稳定型心绞痛与变异型心绞痛的检出率分别为95.52%(64/67),93.94%(31/33),与金标准对比差异无统计学意义(P>0.05)。结论:12导联动态心电图应用于冠心病心绞痛稳定型与变异型分类的临床诊断中效果明显,可为临床治疗提供指导作用,且稳定型心绞痛患者自主神经功能受损程度越严重。
Objective: To study the comparison of clinical diagnostic value of 12-lead dynamic electrocardiogram for stable and variant classification of angina pectoris. Methods: A total of 100 patients with coronary heart disease and angina pectoris admitted to our hospital from August 2015 to August 2017 were selected as study subjects. There were 67 patients in the stable angina group(group A) and 33 patients in the variant angina group(group B). Both groups of patients were given a 12-lead dynamic electrocardiogram. The ST-segment elevation, T-wave towering, ventricular premature beats, U wave inversion situation, and heart rate variability situation in the two groups of patients were compared. The result of coronary angiography was used as the gold standard to analyze the value of 12-lead dynamic electrocardiogram in the diagnosis of stable and variant angina pectoris. Results: The dynamic electrocardiogram of group A 12-lead is characterized by the fact that when the angina pectoris occurs, the horizontal ST-segment depression can be >0.1 m V or extended >0.2 s on the R-based lead in the electrocardiogram, and the T-wave is low-level or inverted. The group B 12-lead dynamic electrocardiogram is characterized when angina pectoris attack ST-segment elevation of leads II, III and a VF in the electrocardiogram, and the ST segment of the corresponding I and a VL leads moved down when angina pectoris attack;The ST segment of the V5 and V6 leads is raised, and the corresponding ST segments of the V1 and V2 leads are moved downward, and after the patient’s angina pectoris, and the ST segment of the ECG can be quickly restored to its original position. The incidence of ST segment elevation, T wave towering, ventricular premature beat and U wave inversion of patients in group A were significantly lower than those in group B(P <0.05). The level of SDNN in group A was significantly lower than that in variant angina group, and the levels of r-MSSD and PNN50 were significantly higher than those in group B(P <0.05). The detection
作者
邬丽娟
WU Li-juan(Function Department,the Sixth People's Hospital of Huizhou,Huizhou 516211,Guangdong Province,P.R.C.)
出处
《中国数字医学》
2019年第12期71-73,共3页
China Digital Medicine
关键词
心绞痛
稳定型
变异型
12导联动态心电图
心率变异型
angina pectoris
stable
variant
12-lead dynamic electrocardiogram
heart rate variant
