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Accuracy of machine electrocardiogram interpretation and implementation of a de-prioritization protocol in the emergency department
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作者 Adam K Stanley Isobel Sonksen +2 位作者 Henry Morgan Nicola Hilton Sukhbir Bhullar 《World Journal of Emergency Medicine》 2025年第5期486-487,共2页
Computer analysis of electrocardiograms(ECGs)was introduced more than 50 years ago,with the aim to improve efficiency and clinical workflow.[1,2]However,inaccuracies have been documented in the literature.[3,4]Researc... Computer analysis of electrocardiograms(ECGs)was introduced more than 50 years ago,with the aim to improve efficiency and clinical workflow.[1,2]However,inaccuracies have been documented in the literature.[3,4]Research indicates that emergency department(ED)clinician interruptions occur every 4-10 min,which is significantly more common than in other specialties.[5]This increases the cognitive load and error rates and impacts patient care and clinical effi ciency.[1,2,5]De-prioritization protocols have been introduced in certain centers in the United Kingdom(UK),removing the need for clinician ECG interpretation where ECGs have been interpreted as normal by the machine. 展开更多
关键词 cognitive load de prioritization protocol improve efficiency clinical workflow howeverinaccuracies computer analysis electrocardiograms ecgs computer analysis electrocardiograms machine electrocardiogram interpretation emergency department error rates
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Artificial intelligence-enabled single-lead electrocardiogram in early detection of ischemic heart disease
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作者 Wen-Hua Song Gary Tse +1 位作者 Kang-Yin Chen Tong Liu 《World Journal of Cardiology》 2025年第7期1-5,共5页
With the rapid advancement and widespread adoption of new artificial intelligence(AI)technologies,personalized medicine and more accurate diagnosis using medical imaging are now possible.Among its many applications,AI... With the rapid advancement and widespread adoption of new artificial intelligence(AI)technologies,personalized medicine and more accurate diagnosis using medical imaging are now possible.Among its many applications,AI has shown remarkable potential in the analysis of electrocardiograms(ECGs),which provide essential insights into the electrical activity of the heart and allowing early detection of ischemic heart disease(IHD).Notably,single-lead ECG(SLECG)analysis has emerged as a key focus in recent research due to its potential for widespread and efficient screening.This editorial focuses on the latest research progress of AI-enabled SLECG utilized in the diagnosis of IHD. 展开更多
关键词 Artificial intelligence Machine learning Ischemic heart disease electrocardiogram DIAGNOSIS
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Image and intracavitary electrocardiogram-guided arm port placement in colorectal cancer: A retrospective comparative study
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作者 Gui-Lan Xie Jing Heng +5 位作者 Xiu-Fen Jia Qian Li Rui Chang Nan Zhang Ling-Ling Xie Chao Gao 《World Journal of Gastrointestinal Surgery》 2025年第10期224-234,共11页
BACKGROUND Arm-implanted totally implantable venous access devices(peripherally inserted central catheter port)have become an important vascular access for colorectal cancer chemotherapy,but traditional anatomical lan... BACKGROUND Arm-implanted totally implantable venous access devices(peripherally inserted central catheter port)have become an important vascular access for colorectal cancer chemotherapy,but traditional anatomical landmark positioning techniques have issues with inaccurate positioning and high complication rates.AIM To evaluate the clinical value of image pre-measurement combined with intracavitary electrocardiogram(IC-ECG)positioning technology in arm port implantation for colorectal cancer patients.METHODS A retrospective analysis was conducted on 216 colorectal cancer patients who received arm port implantation in our hospital from January 2024 to December 2024.Patients were divided into an experimental group(image pre-measurement combined with IC-ECG positioning technology,n=103)and a control group(traditional anatomical landmark positioning technique,n=113).Technical success rate,operation time,catheter tip position accuracy,number of intraoperative catheter adjustments,X-ray exposure time,and postoperative complication rates were compared between the two groups.RESULTS The experimental group demonstrated superior outcomes compared to the control group across all key measures.Technical success rate was higher(98.4%vs 92.7%,P<0.05)with significantly reduced operation time(23.6±5.2 minutes vs 31.5±7.8 minutes,P<0.01).Catheter tip positioning accuracy improved substantially(97.6%vs 85.4%,P=0.002)while X-ray exposure time decreased by 71.8%(5.3±2.1 seconds vs 18.7±4.5 seconds,P<0.001).Threemonth complication rates were markedly lower in the experimental group(4.1%vs 14.6%,P=0.008),including significant reductions in catheter-related thrombosis(0.8%vs 4.9%),displacement(1.6%vs 5.7%),and occlusion(1.6%vs 4.1%).Multivariate analysis identified traditional technique as the strongest risk factor(odds ratio=4.27,P<0.001),while the combined IC-ECG approach was protective(odds ratio=0.34 for displacement,P=0.018).Long-term outcomes favored the experimental group with higher chemotherapy completion rates(97.1%vs 88.5%,P=0.014)and longer catheter dwelling time(189.5±45.3 days vs 162.7±53.8 days,P<0.001).CONCLUSION Image pre-measurement combined with intracavitary electrocardiogram positioning technology in arm port implantation for colorectal cancer patients can significantly improve catheter tip positioning accuracy,reduce operation time and X-ray exposure. 展开更多
关键词 Arm port Colorectal cancer Image pre-measurement Intracavitary electrocardiogram Catheter tip positioning Complications
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Evaluating the Impact of Different Electrocardiogram Methods on Detecting Pacemaker Dysfunction and Cardiac Function Changes in Pacemaker Patients
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作者 Yan Li Chun Zhou +1 位作者 Ying Li Binlin Chen 《Journal of Clinical and Nursing Research》 2025年第8期7-13,共7页
Objective:To investigate the effect of 12-lead electrocardiogram and 24-hour dynamic electrocardiogram in detecting pacemaker dysfunction and changes in cardiac function indexes in patients with pacemaker implantation... Objective:To investigate the effect of 12-lead electrocardiogram and 24-hour dynamic electrocardiogram in detecting pacemaker dysfunction and changes in cardiac function indexes in patients with pacemaker implantation.Methods:A total of 136 patients with pacemaker implantation in the First Clinical Medical College of Three Gorges University,Institute of Cardiovascular Disease of Three Gorges University and Yicang Central People’s Hospital from January 2023 to December 2024 were selected as the research objects.All patients received 12-lead electrocardiogram and 24-hour holter 3–14 days after implantation.Results:The overall detection rate of various types of pacemaker dysfunction by Holter was significantly higher than that by conventional ECG(27.21%vs.5.15%,χ^(2)=24.402,P<0.001).The overall arrhythmia detection rate of Holter was significantly higher than that of conventional electrocardiogram(57.35%vs.10.29%,χ^(2)=67.277,P<0.001).The time domain indexes of heart rate variability obtained by 24-hour continuous monitoring of Holter were significantly improved compared with those of conventional electrocardiogram(P<0.05).Conclusions:Compared with 12-lead electrocardiogram,24-hour holter monitoring can more accurately detect pacemaker dysfunction and arrhythmia in patients with pacemaker implantation,and provide more comprehensive data of heart rate variability,which is helpful for clinicians to better evaluate the cardiac function of patients and adjust treatment plans. 展开更多
关键词 Pacemaker implantation electrocardiogram Abnormal pacemaker function Cardiac arrhythmia Heart rate variability
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A Real-Time Deep Learning Approach for Electrocardiogram-Based Cardiovascular Disease Prediction with Adaptive Drift Detection and Generative Feature Replay
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作者 Soumia Zertal Asma Saighi +2 位作者 Sofia Kouah Souham Meshoul Zakaria Laboudi 《Computer Modeling in Engineering & Sciences》 2025年第9期3737-3782,共46页
Cardiovascular diseases(CVDs)continue to present a leading cause ofmortalityworldwide,emphasizing the importance of early and accurate prediction.Electrocardiogram(ECG)signals,central to cardiac monitoring,have increa... Cardiovascular diseases(CVDs)continue to present a leading cause ofmortalityworldwide,emphasizing the importance of early and accurate prediction.Electrocardiogram(ECG)signals,central to cardiac monitoring,have increasingly been integratedwithDeep Learning(DL)for real-time prediction of CVDs.However,DL models are prone to performance degradation due to concept drift and to catastrophic forgetting.To address this issue,we propose a realtime CVDs prediction approach,referred to as ADWIN-GFR that combines Convolutional Neural Network(CNN)layers,for spatial feature extraction,with Gated Recurrent Units(GRU),for temporal modeling,alongside adaptive drift detection and mitigation mechanisms.The proposed approach integratesAdaptiveWindowing(ADWIN)for realtime concept drift detection,a fine-tuning strategy based on Generative Features Replay(GFR)to preserve previously acquired knowledge,and a dynamic replay buffer ensuring variance,diversity,and data distribution coverage.Extensive experiments conducted on the MIT-BIH arrhythmia dataset demonstrate that ADWIN-GFR outperforms standard fine-tuning techniques,achieving an average post-drift accuracy of 95.4%,amacro F1-score of 93.9%,and a remarkably low forgetting score of 0.9%.It also exhibits an average drift detection delay of 12 steps and achieves an adaptation gain of 17.2%.These findings underscore the potential of ADWIN-GFR for deployment in real-world cardiac monitoring systems,including wearable ECG devices and hospital-based patient monitoring platforms. 展开更多
关键词 Real-time cardiovascular disease prediction concept drift detection catastrophic forgetting fine-tuning electrocardiogram convolutional neural networks gated recurrent units adaptive windowing generative feature replay
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Electrocardiogram Signal Denoising Using Optimized Adaptive Hybrid Filter with Empirical Wavelet Transform
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作者 BALASUBRAMANIAN S NARUKA Mahaveer Singh TEWARI Gaurav 《Journal of Shanghai Jiaotong university(Science)》 2025年第1期66-80,共15页
Cardiovascular diseases are the world’s leading cause of death;therefore cardiac health of the human heart has been a fascinating topic for decades.The electrocardiogram(ECG)signal is a comprehensive non-invasive met... Cardiovascular diseases are the world’s leading cause of death;therefore cardiac health of the human heart has been a fascinating topic for decades.The electrocardiogram(ECG)signal is a comprehensive non-invasive method for determining cardiac health.Various health practitioners use the ECG signal to ascertain critical information about the human heart.In this article,swarm intelligence approaches are used in the biomedical signal processing sector to enhance adaptive hybrid filters and empirical wavelet transforms(EWTs).At first,the white Gaussian noise is added to the input ECG signal and then applied to the EWT.The ECG signals are denoised by the proposed adaptive hybrid filter.The honey badge optimization(HBO)algorithm is utilized to optimize the EWT window function and adaptive hybrid filter weight parameters.The proposed approach is simulated by MATLAB 2018a using the MIT-BIH dataset with white Gaussian,electromyogram and electrode motion artifact noises.A comparison of the HBO approach with recursive least square-based adaptive filter,multichannel least means square,and discrete wavelet transform methods has been done in order to show the efficiency of the proposed adaptive hybrid filter.The experimental results show that the HBO approach supported by EWT and adaptive hybrid filter can be employed efficiently for cardiovascular signal denoising. 展开更多
关键词 electrocardiogram(ECG)signal denoising empirical wavelet transform(EWT) honey badge optimization(HBO) adaptive hybrid filter window function
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参桂汤干预急性心肌缺血模型大鼠心律失常的作用机制
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作者 王凤儒 李凤霞 +5 位作者 李冰菲 吴尘 李国建 周琳琳 郑亚都 徐京育 《中西医结合心脑血管病杂志》 2026年第3期357-364,共8页
目的:通过检测服用参桂汤后急性心肌缺血大鼠心电图及血流动力学指标,探究参桂汤干预心律失常的作用机制。方法:将84只SD大鼠随机分为空白对照组(NC组)、假手术组(Sham组)、模型组(MI组)、胺碘酮组(PC组)、参桂汤高剂量组(SHD组)、参桂... 目的:通过检测服用参桂汤后急性心肌缺血大鼠心电图及血流动力学指标,探究参桂汤干预心律失常的作用机制。方法:将84只SD大鼠随机分为空白对照组(NC组)、假手术组(Sham组)、模型组(MI组)、胺碘酮组(PC组)、参桂汤高剂量组(SHD组)、参桂汤中剂量组(SMD组)、参桂汤低剂量组(SLD组)。灌胃相应剂量药物14 d。结扎左冠状动脉后,分别记录冠状动脉结扎前(0 min)及术后10、30、60、360 min各组大鼠标Ⅱ导联心电图和J点电压值的变化。记录实验血流动力学检测左心室收缩压(LVSP)、左室舒张末压(LVEDP)、心率(HR)、左心室内压最大上升速率(+dp/dt_(max))、左心室内压最大下降速率(-dp/dt_(max))。结果:参桂汤各剂量组及PC组在结扎后10、30、60、360 min均能有效降低J点抬高值,J点抬高程度均明显低于MI组(P<0.01)。与MI组相比,SHD组于结扎后360 min降低J点抬高值更明显(P<0.01);SMD组于结扎后降低J点程度抬高值不如PC组明显(P<0.05),而结扎后10 min与PC组相比差异无统计学意义(P>0.05);SLD组于结扎后各时间点降低J点抬高值均不如PC组明显(P<0.05)。血流动力学检测结果显示,与MI组比较,参桂汤各剂量组LVEDP明显降低(P<0.05或P<0.01),LVSP、+dp/dt_(max)、-dp/dt_(max)、心率明显升高(P<0.05或P<0.01)。结论:参桂汤各剂量组均可以降低冠状动脉结扎大鼠J点抬高电压值,使其处于电稳定状态,且血流动力学检测结果显示参桂汤可显著降低LVEDP值,并能明显升高LVSP、+dp/dt_(max)、-dp/dt_(max)、心率,以高剂量参桂汤、胺碘酮效果更好。 展开更多
关键词 急性心肌缺血 心律失常 参桂汤 胺碘酮 心电图 实验研究
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可穿戴设备在心律失常管理中的应用进展
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作者 黄晓燕 《心电与循环》 2026年第1期1-5,共5页
可穿戴设备是一类基于传感器技术的轻量级便携装置,通过贴近皮肤佩戴的方式实时采集、监测并分析心电等电生理信号,目前已广泛应用于心房颤动等心律失常的早期筛查、长期监测及风险预警。大量临床证据表明,可穿戴设备在心律失常管理中... 可穿戴设备是一类基于传感器技术的轻量级便携装置,通过贴近皮肤佩戴的方式实时采集、监测并分析心电等电生理信号,目前已广泛应用于心房颤动等心律失常的早期筛查、长期监测及风险预警。大量临床证据表明,可穿戴设备在心律失常管理中展现出高灵敏度与特异度,在药物疗效评估、术后随访等临床场景中表现出显著的临床应用价值。然而,当前可穿戴设备仍面临监测准确性欠佳、临床场景整合难度大、数据安全与隐私保护等突出挑战。本文就可穿戴设备在心律失常管理中的应用进展作一述评。 展开更多
关键词 可穿戴设备 心律失常 人工智能 心电监测
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EFFECTS OF BODY TEMPERATURE ON ELECTROCARDIOGRAMS OF LIZARD Eremias multiocellata * 被引量:2
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作者 李仁德 陈强 刘晒发 《Zoological Research》 CAS CSCD 1998年第4期269-276,共8页
Electrocardiograms (ECG) of Eremias multiocellata were studied at 5-35℃ in body temperature. Electrocardiogram wave intervals (R-R,P-R,QRS,T-P,and R-T) shortened while heart rate increased with the increasing of bod... Electrocardiograms (ECG) of Eremias multiocellata were studied at 5-35℃ in body temperature. Electrocardiogram wave intervals (R-R,P-R,QRS,T-P,and R-T) shortened while heart rate increased with the increasing of body temperature. The average heart rate was 14.6/min at 5℃,whereas it was 201/min at 35℃. The duration of wave intervals of ECG and the heart rate were related significantly to the body temperature (P<0.001). Among the components of a cardiac cycle the cardiac rest period (TP intervals) and the atria-ventricular conduction time (PR interval) were affected mostly by body temperature. In the other hand the ventricular depolarization and repolarization (QRS and R-T intervals) were relatively less affected by the body temperature. The increasing of heart rate with body temperature was mainly caused by the shortening of ECG wave intervals,and the T-P interval (the cardiac rest period) was shortened more noticeably than other intervals. 展开更多
关键词 Eremias multiocellata electrocardiogram Body temperature
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一种基于深度特征融合的可解释性12导联心电图自动诊断模型研究
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作者 卢学麒 陈华元 +3 位作者 吴秋岑 温耀棋 刘国光 陈超敏 《南方医科大学学报》 北大核心 2026年第1期208-218,共11页
目的提升12导联心电图(ECG)自动诊断的准确性和可信度。方法提出了一种基于深度特征融合的12导联ECG自动诊断模型(MRHL-ECGNet)。该模型包含多尺度特征提取前端、ResNet-34、全局特征混合模块及时间序列分析模块,首次将Hyena Hierarchy... 目的提升12导联心电图(ECG)自动诊断的准确性和可信度。方法提出了一种基于深度特征融合的12导联ECG自动诊断模型(MRHL-ECGNet)。该模型包含多尺度特征提取前端、ResNet-34、全局特征混合模块及时间序列分析模块,首次将Hyena Hierarchy卷积算子应用于12导联心电图自动诊断任务中,以高效捕捉ECG中的长程依赖关系,并显著降低模型计算复杂度。同时采用基于积分梯度(IG)的可解释性分析技术,实现MRHL-ECGNet决策依据可视化。使用CPSC2018数据集对MRHL-ECGNet进行训练和测试,并采用多项定量评价指标与评估实验对MRHL-ECGNet进行全面评估。结果在测试集上对9种类别ECG的分类任务中,MRHL-ECGNet的准确率、AUC值、F1分数、精确率和召回率分别达到0.972、0.983、0.864、0.873和0.857,均优于其他对比模型,且在GPU上对单样本输出诊断结果所需的时间为0.007s,在CPU上也仅需0.156s,内存占用为67.196MB。结论本研究提出的MRHL-ECGNet不仅具有卓越的分类性能,还具备轻量化及可解释性的特点,在临床ECG辅助诊断中具有较高的应用价值。 展开更多
关键词 心电图自动诊断 深度学习 Hyena Hierarchy卷积算子 模型可解释性
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心电图P波参数在高血压房颤患者消融术后复发预测中的应用价值
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作者 廖琳 陈雪斌 《四川生理科学杂志》 2026年第1期164-166,170,共4页
目的:分析心电图P波参数对高血压心房颤动(Atrial fibrillation,AF)患者消融术后复发的预测价值。方法:回顾性分析2023年1月至2024年10月我院首次接受消融术的87例高血压AF患者资料,参考术后12 m内是否复发分复发组(21例)和非复发组(66... 目的:分析心电图P波参数对高血压心房颤动(Atrial fibrillation,AF)患者消融术后复发的预测价值。方法:回顾性分析2023年1月至2024年10月我院首次接受消融术的87例高血压AF患者资料,参考术后12 m内是否复发分复发组(21例)和非复发组(66例),比较两组P波终末电势(P-wave terminal force in lead V1,PtfV1)、P波离散度(P-wave dispersion,Pd)、P波变异(P-wave variation,Pv)及最大P波时限(Maximum P-wave duration,Pmax),分析上述指标与术后复发的关系及预测价值。结果:与非复发组对比,复发组Pd、Pv、Pmax均更高(P<0.05),但对比两组PtfV1,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,Pd、Pv、Pmax与高血压AF患者术后复发显著相关(P<0.05);绘制受试者工作特征曲线结果显示,Pd、Pv、Pmax三者联合预测高血压AF患者复发的曲线下面积为0.840,均高于单一指标预测(P<0.05)。结论:Pd、Pv、Pmax三者联合在高血压AF患者术后复发中预测价值较高。 展开更多
关键词 高血压 房颤 消融术 心电图P波参数 复发
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血管迷走性晕厥患者直立倾斜试验阳性分型的影响因素分析
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作者 郭露燕 包艳苹 +1 位作者 包丽芳 俞剑昀 《心电与循环》 2026年第1期41-45,55,共6页
目的分析血管迷走性晕厥(VVS)患者直立倾斜试验(HUTT)阳性分型的影响因素。方法回顾性选取2023年1月至2024年12月金华市中心医院因不明原因晕厥的患者199例,收集并比较HUTT阳性与阴性、不同HUTT阳性分型患者性别、基础疾病、心电图参数... 目的分析血管迷走性晕厥(VVS)患者直立倾斜试验(HUTT)阳性分型的影响因素。方法回顾性选取2023年1月至2024年12月金华市中心医院因不明原因晕厥的患者199例,收集并比较HUTT阳性与阴性、不同HUTT阳性分型患者性别、基础疾病、心电图参数及血常规参数等临床资料。采用多因素logistic回归分析HUTT阳性及阳性分型的影响因素。结果HUTT阳性组103例,阴性组96例;两组患者性别、体重指数、QT间期、QTc间期以及红细胞比容(HCT)、嗜中性粒细胞计数、白细胞计数(WBC)、血红蛋白、平均红细胞血红蛋白、血小板计数、单核细胞计数、平均血小板体积比较,差异均有统计学意义(均P<0.05);性别(OR=4.549)、QT间期(OR=1.012)、WBC(OR=0.814)均是HUTT阳性的独立影响因素(均P<0.05)。103例阳性患者中,混合型51例,心脏抑制型9例,血管抑制型43例;不同HUTT阳性分型患者性别、年龄、体重指数、高血压患病率、糖尿病患病率、高脂血症患病率、QRS时间、HCT比较,差异均有统计学意义(均P<0.05)。糖尿病(OR=9.367)、高脂血症(OR=7.539)、性别(OR=5.115)均是HUTT阳性分型为血管抑制型(以混合型为参照)的独立影响因素(均P<0.05)。结论HUTT阳性的VVS患者心电图及血常规参数存在明显差异,而合并糖尿病、高脂血症等基础疾病的男性患者更易诱发血管抑制型VVS。 展开更多
关键词 血管迷走性晕厥 直立倾斜试验 心电图 血常规 影响因素
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Effect of Exogenous Hydrogen Sulfide(H_2S) on the Electrocardiogram(ECG) of Rats Generally Anaesthetized by Zoletil
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作者 冯国峰 冯秀晶 +3 位作者 张卓 梁新江 赵晓红 范宏刚 《Agricultural Science & Technology》 CAS 2016年第8期1896-1899,共4页
Hydrogen sulfide (H2S) is the third gaseous signaling molecule discovered in recent years, and plays an important physiological role in the cardivascular system. To explore the effects of different doses of exogenou... Hydrogen sulfide (H2S) is the third gaseous signaling molecule discovered in recent years, and plays an important physiological role in the cardivascular system. To explore the effects of different doses of exogenous H2S on the electrocardiogram (ECG) of rats generally anesthetized by zoletil, different doses of NariS solution were used for the intervention of intraperitoneal injection 20 rain before the zoletil anesthesia. The ECGs of rats from each treatment group during the time range of 10^th-50^th min were determined under general anesthesia, and then were compared with those from the control group. The results showed that exogenous H2S could significantly reduce the Q-T interval time limit, thus played a role in slowing tachycardia or arrhythmia and other anomalies, thereby protecting the heart. S-T segment and T segment evaluation values were significantly reduced, which might be associated with bradycardia. 展开更多
关键词 Hydrogen sulfide (H2S) electrocardiogram (ECG) Zoletil Anethesia Cardiovascular system
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基于编码器和注意力机制的睡眠呼吸障碍多分类方法
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作者 楼利军 何晓玉 蒋明峰 《电子科技》 2026年第1期73-80,共8页
睡眠呼吸暂停(Sleep Apnea,SA)是一种常见的睡眠障碍。传统多导睡眠图(Polysomnography,PSG)虽然是诊断SA的黄金标准,但耗时且昂贵。为解决该问题,文中提出了一种基于心电图(Electrocardiogram,ECG)和血氧饱和度(Blood Oxygen Saturatio... 睡眠呼吸暂停(Sleep Apnea,SA)是一种常见的睡眠障碍。传统多导睡眠图(Polysomnography,PSG)虽然是诊断SA的黄金标准,但耗时且昂贵。为解决该问题,文中提出了一种基于心电图(Electrocardiogram,ECG)和血氧饱和度(Blood Oxygen Saturation,SpO_(2))信号的新型检测方法。分析了ECG和SpO_(2)特征,利用多尺度卷积神经网络模型(Multi-Scale Convolutional Neural Network,MSCNN)结合Encoder-SE(Squeeze-and-Excitation)网络模型进行特征训练与分类。MSCNN通过获取不同时间长度的ECG和SpO_(2)特征量来增强对分析信号的分析效果。Encoder-SE网络进一步提升了特征的表达能力,通过SE模块自适应地调整特征重要性,确保模型关注关键特征。实验结果表明,所提方法的平均准确率为93.29%,为SA的临床诊断和治疗提供了新思路与有效工具。 展开更多
关键词 睡眠呼吸暂停综合征 深度学习 心电图 外周血氧饱和度 多模态卷积神经网络 特征融合 编码器 注意力机制
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心电图联合血清IL-33、ANGPTL3对急性心肌梗死患者PCI术后主要不良心血管事件发生的预测价值
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作者 钱华 童睿 +1 位作者 任姝凡 刘艳 《疑难病杂志》 2026年第1期8-13,共6页
目的 探讨心电图联合血清白介素-33(IL-33)、血管生成素样蛋白3(ANGPTL3)对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)发生的预测价值。方法 选取2021年8月—2024年12月西安交通大学第一附属医院心... 目的 探讨心电图联合血清白介素-33(IL-33)、血管生成素样蛋白3(ANGPTL3)对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)发生的预测价值。方法 选取2021年8月—2024年12月西安交通大学第一附属医院心内科治疗的AMI患者110例为研究对象,根据PCI术后6个月随访结果将患者分为MACE组(n=32)和非MACE组(n=78)。ELISA法测定患者血清IL-33、ANGPTL3水平;采用Logistic回归分析AMI患者PCI术后MACE发生的影响因素;受试者工作特征(ROC)曲线分析心电图联合血清IL-33、ANGPTL3对AMI患者PCI术后MACE的预测价值。结果 与非MACE组比较,MACE组患者年龄高、发病至PCI治疗时间长、病变血管≥3支比例高、罪犯血管为左主干比例高、发病前服用抗血小板药物比例低(χ^(2)/t/P=1.991/0.049,4.156/<0.001,7.678/0.006,4.250/0.039,4.198/0.040);MACE组患者的心电图T波倒置发生率、血清IL-33和ANGPTL3水平均高于非MACE组(χ^(2)/P=16.206/0.013,t/P=6.209/<0.001,6.021<0.001);发生T波倒置、血清IL-33、ANGPTL3水平升高为影响AMI患者PCI术后发生MACE的危险因素[OR(95%CI)=1.994(1.067~3.726),2.145(1.119~4.112),2.317(1.403~3.827)];心电图联合血清IL-33、ANGPTL3预测AMI患者PCI术后发生MACE的AUC分别为0.865、0.837、0.816、0.986,三项联合优于各自单独预测价值(Z/P=5.075/<0.001、3.424/0.001、3.640/<0.001)。T波倒置、血清IL-33水平升高、血清ANGPTL3升高预测AMI患者PCI术后6个月发生MACE的正确率分别为68.18%、80.00%、82.73%,三者联合的正确率为91.82%,显著高于三项指标单独预测(χ^(2)/P=19.205/<0.001、6.346/0.012、4.092/0.043)。结论 心电图T波倒置及血清IL-33、ANGPTL3升高是影响AMI患者PCI术后MACE发生的独立危险因素,三者联合对MACE发生预测的价值更高。 展开更多
关键词 急性心肌梗死 心电图 白介素-33 血管生成素样蛋白3 经皮冠状动脉介入治疗 主要不良心血管事件 预测
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低钾血症致房室传导阻滞的临床和心电图特点研究
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作者 俞晓蓉 《罕少疾病杂志》 2026年第2期82-84,88,共4页
目的探讨低钾血症致房室传导阻滞的临床和心电图特点。方法回顾性分析本院2023年1月至12月期间收治的60例低钾血症致房室传导阻滞患者(研究组)与60例单纯低钾血症患者(对照组)的临床资料,统计两组患者的临床指标(血清钾、心肌酶等)与心... 目的探讨低钾血症致房室传导阻滞的临床和心电图特点。方法回顾性分析本院2023年1月至12月期间收治的60例低钾血症致房室传导阻滞患者(研究组)与60例单纯低钾血症患者(对照组)的临床资料,统计两组患者的临床指标(血清钾、心肌酶等)与心电图特点,将研究组患者按轻、中、重度低钾血症分为三个亚组,比较各亚组患者的房室传导阻滞病情严重度,了解研究组其他心律失常与电解质紊乱的发生情况。结果研究组血清钾低于对照组,天门冬氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶水平均高于对照组,P<0.05。研究组心率与心率加速力低于对照组,心率减速力、RR间期总体标准差与均值标准差、相邻RR间期差值的均方根均高于对照组,P<0.05。不同分级低钾血症患者二度房室传导阻滞发生率比较无显著差异,P>0.05;中度与重度组一度房室传导阻滞发生率高于轻度组,重度组三度房室传导阻滞发生率高于轻度与中度组,P<0.05。大部分研究组患者同时合并其他心律失常与电解质紊乱情况,其中,心律失常以室性期前收缩、ST段改变等为主;电解质紊乱主要包含低血钠、低血镁、低血钙、低血氯等。结论与单纯低钾血症患者相比,低钾血症致房室传导阻滞患者的血清钾及相关心肌酶水平相对更低,心电图指标异常程度更高,且低钾血症分级越高所引起的房室传导阻滞可能越严重,而低钾血症致房室传导阻滞患者普遍同时存在多种心律失常与电解质紊乱情况。 展开更多
关键词 低钾血症 房室传导阻滞 血清钾 心肌酶 心电图 心律失常
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主动脉夹层误诊为急性心肌梗死临床分析
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作者 贾亚婧 杜密稳 李翔华 《临床误诊误治》 2026年第3期7-13,共7页
目的分析主动脉夹层误诊为急性心肌梗死的原因,总结纠正误诊方法,以提高临床医师诊治水平。方法回顾分析2020年6月至2023年6月收治的2例主动脉夹层误诊为急性心肌梗死患者的临床资料。结果1例因胸痛伴呕吐3 h就诊,根据临床症状、入院查... 目的分析主动脉夹层误诊为急性心肌梗死的原因,总结纠正误诊方法,以提高临床医师诊治水平。方法回顾分析2020年6月至2023年6月收治的2例主动脉夹层误诊为急性心肌梗死患者的临床资料。结果1例因胸痛伴呕吐3 h就诊,根据临床症状、入院查体及心电图检查显示窦性心律、胸导联T波改变(V3~V4低平、V5~V6浅倒置),初诊考虑急性心肌梗死及高血压病3级(极高危)予对症治疗。治疗第2天患者胸痛突然加剧难以忍受,再次行心电图检查、实验室检查、主动脉CT血管成像检查,最终诊断为降主动脉夹层DeBakeyⅢ型,并伴有双侧胸腔积液。误诊时间24 h。内科对症治疗1周后病情缓解转外院行主动脉支架置入手术,手术顺利,患者恢复良好。1例因突发胸骨后撕裂样剧痛1 h就诊,根据临床症状、查体及床旁心电图结果诊断为急性下壁ST段抬高型心肌梗死,立即给予对症治疗。治疗期间进一步实验室检查,并组织专家会诊,家属拒绝行冠状动脉造影检查,签署知情同意书后给予静脉溶栓等治疗2 h,患者胸痛无明显缓解,再次行床旁全导心电图、床旁心脏超声、主动脉超声及主动脉增强CT检查,更正诊断为主动脉夹层(Stanford分型A型)。误诊时间2 h。患者及家属拒绝转院手术治疗,经保守治疗14 d,患者病情好转出院。患者于出院后第7个月因心力衰竭抢救无效死亡。结论主动脉夹层患者容易被误诊为急性心肌梗死,并因此给予不恰当治疗。临床医师应提高警惕,注意二者的鉴别要点,详细问诊及仔细查体,并尽早采取有针对性的影像学检查,以减少或避免主动脉夹层误诊误治。 展开更多
关键词 主动脉夹层 误诊 急性心肌梗死 鉴别诊断 心电图 CT血管成像 胸痛
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42例甲状腺功能亢进患者的心电图表现研究
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作者 周霞平 《罕少疾病杂志》 2026年第2期46-48,共3页
目的探讨甲状腺功能亢进(以下简称“甲亢”)患者的心电图表现。方法回顾性分析我院2023年1月至12月收治的42例甲亢患者的临床资料,统计所有患者的心电图检查结果及主要表现,并比较不同特征患者的心电图异常率。结果在这42例甲亢患者中,... 目的探讨甲状腺功能亢进(以下简称“甲亢”)患者的心电图表现。方法回顾性分析我院2023年1月至12月收治的42例甲亢患者的临床资料,统计所有患者的心电图检查结果及主要表现,并比较不同特征患者的心电图异常率。结果在这42例甲亢患者中,有15例患者治疗前的24h动态心电图检查结果正常,占比35.71%;另外27例(64.29%)患者24h动态心电图检查结果异常,主要表现为:窦性心动过速、窦性心动过缓、房颤、左室肥厚、室早/室速、房早/房速、房室传导阻滞、束支传导阻滞、QT间期延长、T波异常等情况。与治疗前相比,患者治疗后的心率与心率加速力明显降低,心率减速力、低频功率、高频功率、RR间期总体标准差、RR间期平均值的标准差、相邻RR间期差值的均方根均明显升高,P<0.05。结论大部分甲亢患者在接受正规治疗前的心电图检查结果存在异常,表现形式多样,且这种异常情况在年龄较高及病程较长的甲亢患者中更为显著,临床需加强对甲亢患者的心电监护,及时根据其心电图表现评估其存在的异常情况及相关风险,并由此选择合适的治疗与护理干预措施,为患者提供更多安全保障,进一步改善其预后情况。 展开更多
关键词 甲状腺功能亢进 心电图表现 窦性心动过速 房颤 房室传导阻滞
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心电图参数在左心室肥厚诊断中的价值研究
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作者 叶卉 井婷婷 李炙星 《四川生理科学杂志》 2026年第2期284-286,共3页
目的:探讨R波振幅指数(RLI)+SV4与Sokolow-Lyon电压标准联合应用在优化左心室肥厚(LVH)诊断灵敏度、特异度中的价值。方法:选取2023年1月至2024年12月期间于本院就诊的151例原发性高血压患者作为研究对象。根据超声心动图检查中左心室... 目的:探讨R波振幅指数(RLI)+SV4与Sokolow-Lyon电压标准联合应用在优化左心室肥厚(LVH)诊断灵敏度、特异度中的价值。方法:选取2023年1月至2024年12月期间于本院就诊的151例原发性高血压患者作为研究对象。根据超声心动图检查中左心室质量指数(LVMI)将患者分为LVH组(58例)和左心室正常组(93例)。两组均进行心电图及超声心动图检查。分析对比两组的超声心动图参数[收缩压、舒张压、舒张末期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室内径(LVDd)、左心室质量指数(LVMI)];分析对比两组的心电图参数(RLI、SV4及Sokolow-Lyon电压)。分析RLI+SV4、Sokolow-Lyon标准及两者联合检查的灵敏度、特异度、准确度。采用Kappa检验评估各诊断标准与“LVMI”的一致性。结果:LVH组的收缩压、舒张压、LVMI、IVST、LVPWT、LVDd均显著高于正常组(P<0.05);而两组的BSA无显著差异(P>0.05)。LVH组的RLI、SV4及Sokolow-Lyon电压均显著高于正常组(P<0.05)。联合标准的诊断灵敏度(91.38%)、特异度(92.47%)、准确度(92.05%)及与“LVMI”Kappa值(0.783)均显著高于RLI+SV4、Sokolow-Lyon电压标准单独检测(P<0.05)。结论:RLI+SV4联合Sokolow-Lyon电压标准诊断LVH,具有较高的灵敏度与特异度,与超声心动图检查的一致性较高。 展开更多
关键词 心电图参数 RLI+SV4 Sokolow-Lyon电压 左心室肥厚 灵敏度 特异度
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