摘要
目的分析急性心肌梗死(AMI)患者行心电图诊断的价值。方法该研究主体为2018年7月—2020年3月间来该院治疗的86例AMI患者。对其进行心电图诊断,分析典型心电图变化概率、心电图表现、患者死亡例数与死因。将冠状动脉造影(CAG)结果作为病理诊断标准,对比心电图对于梗死部位的检出率和诊断准确率、敏感度、特异度等指标。结果 86例AMI患者中,伴有典型心电图变化的概率为75.58%。表现为ST段与Q波抬高且T波倒置;胸腔导联R呈递增趋势,且ST段抬高。非典型心电图变化的概率为24.42%。表现为ST段降低且T波低平或倒置,T波倒置或低平,ST段正常。所有患者中,死亡9例,死因为心力衰竭(33.33%),心源性休克(11.11%),恶性心律失常(55.56%),且8例患者年龄>65岁。心电图的下壁梗死检出率为59.30%,病理诊断为61.63%,差异无统计学意义(χ^(2)=0.097,P=0.755);心电图的右室梗死检出率为18.60%,病理诊断为17.44%,差异无统计学意义(χ^(2)=0.039,P=0.843);心电图的前间壁梗死检出率为12.79%,病理诊断为13.95%,差异无统计学意义(χ^(2)=0.050,P=0.823);心电图的前壁梗死检出率为9.30%,病理诊断为6.98%,差异无统计学意义(χ^(2)=0.311,P=0.577)。心电图的诊断敏感度为97.56%,诊断特异度为75.00%,诊断准确率为96.51%。结论为AMI患者行心电图检查可有效确定梗死部位,发现心电图异常表现,分析患者死亡的高危因素,具有较高的诊断精准性,可作为该病的常规诊断技术。
Objective To analyze the diagnostic value of electrocardiogram in patients with acute myocardial infarction(AMI).Methods The subjects of this study were 86 patients with AMI who came to the hospital for treatment from July 2018 to March 2020.Perform electrocardiogram diagnosis,analyzed the probability of typical electrocardiogram changes,electrocardiogram performance,the number of deaths and the cause of death.The results of coronary angiography(CAG)were used as the pathological diagnostic criteria,and the ECG's detection rate of infarcts and the diagnostic accuracy,sensitivity,specificity and other indicators were compared.Results Among 86 patients with AMI,the probability of accompanied by typical ECG changes was 75.58%.It was manifested as ST-segment and Q-wave elevation and T-wave inversion;chest lead R showed an increasing trend,and ST-segment elevation increased.The probability of atypical ECG changes was 24.42%.It was manifested as ST-segment decrease and T-wave low and flat or inverted,T-wave inverted or low-flat,ST-segment was normal.Among all the patients,9 died,the cause of death was heart failure(33.33%),cardiogenic shock(11.11%),malignant arrhythmia(55.56%),and 8 patients were older than 65 years old.The detection rate of inferior wall infarction on the electrocardiogram was 59.30%,and the pathological diagnosis was 61.63%,the difference was not statistically significant(χ^(2)=0.097,P=0.755);the detection rate of right ventricular infarction on the electrocardiogram was 18.60%,and the pathological diagnosis was 17.44%,the difference was not statistically significant(χ^(2)=0.039,P=0.843);the detection rate of anterior septal wall infarction on ECG was 12.79%,and the pathological diagnosis was 13.95%,the difference was not statistically significant(χ^(2)=0.050,P=0.823);the detection rate of anterior wall infarction on ECG was 9.30%,and the pathological diagnosis was 6.98%,the difference was not statistically significant(χ^(2)=0.311,P=0.577).The diagnostic sensitivity of electrocardiogram was 97.56%,the diagnostic specificity was 75.00%,and the diagnostic accuracy rate was 96.51%.Conclusion ECG examination for AMI patients can effectively determine the location of infarction,find abnormal ECG performance,analyze high-risk factors of patient death,and have high diagnostic accuracy,which can be used as a routine diagnostic technique for the disease.
作者
张甜甜
ZHANG Tiantian(ECG Room,Laiwu Central Hospital of Xinwen Mining Group,Jinan,Shandong Province,271100 China)
出处
《世界复合医学》
2021年第4期56-58,共3页
World Journal of Complex Medicine
关键词
急性心肌梗死
心电图
诊断
梗死部位
Acute myocardial infarction
Electrocardiogram
Diagnosis
Infarct location
