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目的分析心电图对陈旧性心肌梗死的诊断价值及漏诊原因。方法于2015年3月-2016年3月,选择在该院治疗的陈旧性心肌梗死患者60例作为研究对象,对所有患者进行心电图检测,分析心电图的诊断价值。对心梗组患者的一般资料进行分析,统计患者漏诊影响因素。结果心电图检测陈旧性心肌梗死正确28例,漏诊32例,漏诊率53.3%。不同性别、年龄患者心电图检测陈旧性心肌梗死诊断漏诊率比较,差异无统计学意义(P>0.05)。冠状动脉病变支数≥3支、合并心脑血管危险因素≥3个的患者心电图检测漏诊率明显高于冠状动脉病变支数1~2支、合并心脑血管危险因素1~2个的患者,差异均有统计学意义(P<0.05)。结论心电图诊断陈旧性心肌梗死特异性高,但诊断敏感性及准确率较低,易出现漏诊。且其漏诊与冠状动脉病变支数、合并心脑血管危险因素数量之间存在关联。
Objective To analyze the diagnostic value and cause of missed diagnosis of old myocardial infarction by electrocardiogram. Methods From March 2015 to March 2016, 60 patients with old myocardial infarction who were treated in this hospital were selected as the research object. All the patients were examined by electrocardiogram and the diagnostic value of electrocardiogram was analyzed. The general data of patients with myocardial infarction were analyzed, and the influencing factors of missed diagnosis were statistically analyzed. The results of electrocardiogram detection of correct old myocardial infarction in 28 cases, 32 cases of missed diagnosis, missed diagnosis rate of 53.3%. There was no significant difference in the rate of misdiagnosis between patients with different gender and age in diagnosing old myocardial infarction by electrocardiogram (P> 0.05). The number of coronary artery lesions was ≥3, and the misdiagnosis rate of electrocardiogram in patients with ≥3 cardiac and cerebral risk factors was significantly higher than those with 1-2 coronary artery lesions. Patients with cardiovascular and cerebrovascular risk factors of 1 or 2, The differences were statistically significant (P <0.05). Conclusion ECG diagnosis of old myocardial infarction with high specificity, but the diagnostic sensitivity and accuracy is low, prone to missed diagnosis. There was a correlation between the missed diagnosis and the number of coronary artery lesions and the number of cardiovascular and cerebrovascular risk factors.