摘要
目的:分析24h动态心电图在中老年冠心病并发无症状心肌缺血中的早期诊断价值。方法:以2016年11月-2018年8月本院收治的150例中老年冠心病患者作为对象,均以常规心电图及24h动态心电图进行诊断,并以冠脉造影结果为依据,比较其诊断的敏感度、特异度、准确度和阴性预测值、阳性预测值。结果:经标准下150例患者均符合无症状心肌缺血诊断标准,常规心电图无症状心肌缺血检验正确率为73.33%,较24h动态心电图的88.67%低(X^2=11.457,P<0.05);24h动态心电图发现无症状心肌缺血主要在06:01-12:00发作,其发生率高于其他时间段,差异有统计学意义(P<0.05);无症状心肌缺血患者中,快频率发作率为84.97%,高于慢频率的15.03%,差异有统计学意义(P<0.05);24h动态心电图对无症状心肌缺血的检测敏感度、特异度、准确度和阴性预测值、阳性预测值均高于常规心电图,差异有统计学意义(P<0.05)。结论:中老年冠心病患者施予24h动态心电图检查可实现对无症状心肌缺血的早期诊断,还能明确患者无症状心肌缺血主要发作时间及其发作频率等,应用价值显著。
Objective: To analyze the early diagnostic value of 24-hour dynamic electrocardiogram(DCG) in the elderly with coronary heart disease and silent myocardial ischemia. Method: A total of 150 middle-aged and elderly patients with coronary heart disease admitted to our hospital from November 2016 to August 2018 were all diagnosed by routine ECG and 24-hour DCG. Based on the results of coronary angiography, the sensitivity, specificity, accuracy, negative and positive predictive values of the diagnosis were compared. Result: According to the standard, all 150 patients met the diagnosis standard of silent myocardial ischemia. The correct rate of silent myocardial ischemia in routine ECG was 73.33%, which was lower than 88.67% in 24-hour DCG( X^2=11.457, P<0.05). 24-hour DCG found that silent myocardial ischemia mainly occurred at 06:01-12:00, which was higher than other time periods(P<0.05). In silent myocardial ischemia patients, the fast frequency attack rate was 84.97%, which was higher than 15.03% of the slow frequency(P<0.05). The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 24-hour DCG for silent myocardial ischemia were higher than those of routine ECG(P<0.05). Conclusion: 24-hour DCG can be used for the early diagnosis of middle-aged and elderly patients with coronary heart disease and silent myocardial ischemia, and the main attack time and frequency of silent myocardial ischemia can also be determined.
作者
叶海容
邱丹丹
YE Hairong;QIU Dandan(Jiangxi Chest Hospital,Nanchang 330006,China)
出处
《中国医学创新》
CAS
2019年第34期123-126,共4页
Medical Innovation of China
关键词
24H动态心电图
中老年
冠心病
无症状心肌缺血
早期诊断
24-hour dynamic electrocardiogram
Middle aged and elderly patients
Coronary heart disease
Silent myocardial ischemia
Early diagnostic
