24h动态心电图诊断冠心病心律失常的准确度与漏诊率评估OA
Evaluation of Accuracy And Missed Diagnosis Rate of 24-hour Dynamic Electrocardiogram in Diagnosing Arrhythmia of Coronary Heart Disease
目的 评估 24 h 动态心电图诊断冠心病心律失常的准确度与漏诊率.方法 选取 2022 年 5 月至 2024 年 7 月广东省江门市新会区中医院收治的 200 例冠心病患者为研究对象,根据是否合并心律失常进行分组,将 114 例发生心律失常的患者纳入心律失常组,86 例未发生心律失常的患者纳入无心律失常组.两组均分别进行常规心电图、动态心电图检查,分析二者对冠心病心律失常的诊断价值及对不同类型心律失常的检出率.结果 常规心电图检查诊断冠心病心律失常的阳性例数为 107 例,占比 53.50%;阴性例数为 93 例,占比 46.50%,与金标准具有中等一致性(Kappa=0.445,P<0.05);动态心电图诊断冠心病心律失常的阳性例数为 121 例,占比 60.50%;阴性例数为 79例,占比 39.50%,与金标准具有极高一致性(Kappa=0.845,P<0.05);动态心电图的灵敏度、特异度、准确度均为最高,分别为 96.49%、87.21%、92.50%,且两种检查方式的灵敏度、特异度、准确度差异有统计学意义(P<0.05);动态心电图对室性早搏单发、室性早搏二、三联律、室性早搏成对、房性早搏单发、房性早搏二、三联律、房性早搏成对、房室传导阻滞、短阵室上速的检出率均高于常规心电图,但仅室性早搏二、三联律、室性早搏成对、房性早搏二、三联律、房性早搏成对、短阵室上速差异有统计学意义(P<0.05).结论 采取 24 h 动态心电图诊断冠心病心律失常可极大程度地提高诊断准确率,并可有效识别不同的心律失常.
Objective:To evaluate the accuracy and missed diagnosis rate of 24 h dynamic electrocardiogram(DCG)in diagnosing arrhythmia of coronary heart disease.Methods:From May 2022 to July 2024,200 patients with coro-nary heart disease in Xinhui District Hospital of Jiangmen City,Guangdong Province were selected as the research object,and divided into two groups according to whether they were complicated with arrhythmia.114 patients with arrhythmia were included in the arrhythmia group,and 86 patients without arrhythmia were included in the ar-rhythmia group.Both groups were examined by routine electrocardiogram and dynamic electrocardiogram respec-tively,and their diagnostic value for arrhythmia of coronary heart disease and the detection rate of different types of arrhythmia were analyzed.Results:The number of positive cases diagnosed by routine electrocardiogram was 107,accounting for 53.50%.The number of negative cases was 93,accounting for 46.50%,which was consistent with the gold standard(Kappa=0.445,P<0.05).The number of positive cases of arrhythmia diagnosed by dynamic e-lectrocardiogram was 121,accounting for 60.50%.The number of negative cases was 79,accounting for 39.50%,which was very consistent with the gold standard(Kappa=0.845,P<0.05).The sensitivity,specificity and accu-racy of dynamic electrocardiogram were the highest,which were 96.49%、87.21%and 92.50%,respectively,and the difference between the two methods was statistically significant(P<0.0 5).The detection rates of single ven-tricular premature beat,ventricular premature beat Ⅱ、triad、ventricular premature beat pair、atrial premature beatⅡ、triad、atrial premature beat pair、atrioventricular block and short-term supraventricular tachycardia by dynamic electrocardiogram are higher than those by routine electrocardiogram,but only ventricular premature beat Ⅱ、triad、ventricular premature beat pair、atrial premature beat Ⅱ、triad and atrial premature beat formation.Conclusion:U-sing 24-hour dynamic electrocardiogram to diagnose arrhythmia of coronary heart disease can greatly improve the diagnostic accuracy and effectively identify different arrhythmias.
张枝花
广东省江门市新会区中医院心电图科,广东 江门 529100
医药卫生
24h动态心电图冠心病心律失常准确度漏诊率
24 h dynamic electrocardiogramArrhythmia of coronary heart diseaseAccuracyMissed diagnosis rate
《生命科学仪器》 2026 (2)
71-74,4
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