摘要
目的分析冠状动脉粥样硬化性心脏病诊断中动态心电图、常规心电图临床应用效果及诊断价值。方法抽选2023年2月至2024年3月接诊疑似冠状动脉粥样硬化性心脏病患者120例为研究对象,行回顾性临床研究,患者入院后均接受常规心电图、动态心电图及冠状动脉造影检查(CTA)。以冠脉造影诊断结果为金标准,分析常规心电图、动态心电图对冠心病的诊断效能;比较常规心电图、动态心电图对冠心病确诊者心律失常、心肌缺血检出率差异;比较伴心肌缺血、无心肌缺血冠心病患者动态心电图参数差异。结果动态心电图对冠心病诊断敏感度、特异度、阴性预测值及准确度均高于常规心电图诊断(P<0.05);相较常规心电图,动态心电图对冠心病患者室性心律失常、房性心律失常检出率,房室传导阻滞、室上性心动过速检出率及心肌缺血检出率升高(P<0.05);相较无心肌缺血者,伴心肌缺血冠心病者ST段下移次数、下移幅度、下移持续时间及日间起始HR、夜间HR,心肌缺血持续时间升高(P<0.05)。结论动态心电图对冠心病具有确切诊断效果,且可积极筛查冠心病患者心律失常、心肌缺血并发情况,为患者临床预后评估提供丰富ST段下移参数、HR参数,临床应用价值确切。
Objective To analyze the clinical application effect and diagnostic value of holter electrocardiogram and routine electrocardiogram in the diagnosis of coronary atherosclerotic heart disease.Methods a total of 120 patients with suspected coronary arteriosclerosis 2023 from February to march were randomly selected and 2024 a retrospective clinical study,all patients underwent routine ECG,Holter monitor and coronary angiography(CTA).The clinical diagnostic efficacy of routine electrocardiogram(ECG)and Holter monitor electrocardiogram(ECG)in patients with coronary heart disease(CHD)was analyzed,and compared with that of Holter monitor electrocardiogram(ECG)in patients with confirmed CHD,to compare the difference of Holter monitor parameters between coronary heart disease patients with and without myocardial ischemia.Results The sensitivity,specificity,negative predictive value and accuracy of holter ECG were higher than those of conventional ECG(P<0.05).Compared with conventional ECG,the detection rates of ventricular arrhythmia,atrial arrhythmia,atrioventricular block,supraventricular tachycardia and myocardial ischemia in patients with coronary heart disease were increased by holter ECG(P<0.05).Compared with those without myocardial ischemia,the number,amplitude and duration of ST segment downshift,daytime onset HR and nighttime HR were increased in patients with myocardial ischemic coronary artery disease(P<0.05).Conclusions the Holter Monitor has a definite diagnostic effect on coronary heart disease and can actively screen the complications of arrhythmia and myocardial ischemia in patients with coronary heart disease,it can provide abundant ST-segment depression parameters and HR parameters for the evaluation of clinical prognosis.
作者
周洪福
肖燕榕
ZHOU Hongfu;XIAO Yanrong(Department of Electrocardiogram,Sanming Second Hospital,Sanming 366000,China)
出处
《中国医药指南》
2024年第31期107-109,共3页
Guide of China Medicine
关键词
动态心电图
常规心电图
冠状动脉粥样硬化
心脏病
Holter Monitor
Routine electrocardiogram
Coronary atherosclerosis
Heart disease
