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目的探讨动态心电图在冠心病无症状性心肌缺血中的诊断价值。方法回顾性分析郑州市中医院94例冠心病患者临床资料,患者均行冠状动脉造影、常规心电图、动态心电图等检查,以冠状动脉造影作为金标准,统计比较常规心电图及动态心电图无症状心肌缺血特异度、敏感度及符合率。结果 94例患者中经冠脉造影检查诊断出无症状心肌缺血68例,应用动态心电图检查出无症状心肌缺血57例,诊断特异度为53.85%(14/26),敏感度为83.82%(57/68),符合率为75.53%(71/94);常规心电图检查出无症状心肌缺血39例,诊断特异度为34.62%(9/26),敏感度为57.35%(39/68),符合率为51.06%(48/94),动态心电图诊断敏感度、符合率均高于常规心电图,差异具有统计学意义(P<0.05)。结论在冠心病无症状性心肌缺血中应用动态心电图可显著提高诊断符合率,具有较高诊断价值。
Objective To investigate the diagnostic value of ambulatory electrocardiogram in asymptomatic myocardial ischemia in patients with coronary heart disease. Methods The clinical data of 94 patients with coronary heart disease in Zhengzhou Hospital of Traditional Chinese Medicine were retrospectively analyzed. All patients underwent coronary angiography, routine electrocardiogram and dynamic electrocardiogram. Coronary angiography was used as the gold standard to compare conventional electrocardiogram and ambulatory electrocardiographic asymptomatic Blood specificity, sensitivity and coincidence rate. Results Among the 94 patients, 68 cases of asymptomatic myocardial ischemia were diagnosed by coronary angiography, and 57 cases of asymptomatic myocardial ischemia were detected by dynamic electrocardiogram. The diagnostic specificity was 53.85% (14/26) and the sensitivity was 83.82% (57/68), and the coincidence rate was 75.53% (71/94). There were 39 cases with asymptomatic myocardial ischemia in conventional electrocardiography, the diagnostic specificity was 34.62% (9/26) and the sensitivity was 57.35% (39/68 ), The coincidence rate was 51.06% (48/94). The diagnostic sensitivity and the coincidence rate of ambulatory electrocardiogram were higher than those of conventional electrocardiogram. The difference was statistically significant (P <0.05). Conclusion The application of ambulatory electrocardiogram in asymptomatic myocardial ischemia of coronary heart disease can significantly improve the diagnostic coincidence rate, which has a high diagnostic value.