海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2015年
15期
2246-2248
,共3页
陈芬兰%邱健%李叶阔%曾凡杰
陳芬蘭%邱健%李葉闊%曾凡傑
진분란%구건%리협활%증범걸
超声心动图%心电图QRS碎裂波%心肌梗死%价值
超聲心動圖%心電圖QRS碎裂波%心肌梗死%價值
초성심동도%심전도QRS쇄렬파%심기경사%개치
Echocardiogram%Electrocardiogram QRS wave%Myocardial infarction%Value
目的：观察超声心动图联合心电图QRS碎裂波在心肌梗塞诊断和预后评估中的应用价值。方法选择我院2014年1~12月确诊的心肌梗塞患者97例，根据心肌梗塞类型分为两组，其中急性心肌梗塞(AMI)61例，设为AMI组；陈旧性心肌梗塞(OMI)36例，设为OMI组，以冠状动脉造影术诊断结果为“金标准”，对超声心动图及联合心电图QRS碎裂波检查、分类、危险分层及预后评价情况进行分析，观察其在不同阶段、不同类型心肌梗死患者中的敏感性和预后评估价值。结果超声心动图对AMI和OMI的诊断准确率分别为78.69%和44.44%，AMI组的准确率明显高于OMI组，两组比较差异具有统计学意义(P<0.05)。根据检查结果将患者分为三组，高危组患者多支血管病变者占94.12%，52.94%的患者完全闭塞，构成比明显高于中危组和低危组，差异均具有统计学意义(P<0.05)。高危组Ⅲ级、ⅣA级、ⅣB级患者的构成比分别为20.59%、47.06%、32.35%，ⅣA级、ⅣB级患者的比例明显高于中危组和低危组，差异具有统计学意义(P<0.05)。结论超声心动图对心肌梗塞具有较高的诊断价值，两项指标联合检测对梗塞程度的确定、预后的评估具有一定的意义。
目的：觀察超聲心動圖聯閤心電圖QRS碎裂波在心肌梗塞診斷和預後評估中的應用價值。方法選擇我院2014年1~12月確診的心肌梗塞患者97例，根據心肌梗塞類型分為兩組，其中急性心肌梗塞(AMI)61例，設為AMI組；陳舊性心肌梗塞(OMI)36例，設為OMI組，以冠狀動脈造影術診斷結果為“金標準”，對超聲心動圖及聯閤心電圖QRS碎裂波檢查、分類、危險分層及預後評價情況進行分析，觀察其在不同階段、不同類型心肌梗死患者中的敏感性和預後評估價值。結果超聲心動圖對AMI和OMI的診斷準確率分彆為78.69%和44.44%，AMI組的準確率明顯高于OMI組，兩組比較差異具有統計學意義(P<0.05)。根據檢查結果將患者分為三組，高危組患者多支血管病變者佔94.12%，52.94%的患者完全閉塞，構成比明顯高于中危組和低危組，差異均具有統計學意義(P<0.05)。高危組Ⅲ級、ⅣA級、ⅣB級患者的構成比分彆為20.59%、47.06%、32.35%，ⅣA級、ⅣB級患者的比例明顯高于中危組和低危組，差異具有統計學意義(P<0.05)。結論超聲心動圖對心肌梗塞具有較高的診斷價值，兩項指標聯閤檢測對梗塞程度的確定、預後的評估具有一定的意義。
목적：관찰초성심동도연합심전도QRS쇄렬파재심기경새진단화예후평고중적응용개치。방법선택아원2014년1~12월학진적심기경새환자97례，근거심기경새류형분위량조，기중급성심기경새(AMI)61례，설위AMI조；진구성심기경새(OMI)36례，설위OMI조，이관상동맥조영술진단결과위“금표준”，대초성심동도급연합심전도QRS쇄렬파검사、분류、위험분층급예후평개정황진행분석，관찰기재불동계단、불동류형심기경사환자중적민감성화예후평고개치。결과초성심동도대AMI화OMI적진단준학솔분별위78.69%화44.44%，AMI조적준학솔명현고우OMI조，량조비교차이구유통계학의의(P<0.05)。근거검사결과장환자분위삼조，고위조환자다지혈관병변자점94.12%，52.94%적환자완전폐새，구성비명현고우중위조화저위조，차이균구유통계학의의(P<0.05)。고위조Ⅲ급、ⅣA급、ⅣB급환자적구성비분별위20.59%、47.06%、32.35%，ⅣA급、ⅣB급환자적비례명현고우중위조화저위조，차이구유통계학의의(P<0.05)。결론초성심동도대심기경새구유교고적진단개치，량항지표연합검측대경새정도적학정、예후적평고구유일정적의의。
Objective To observe the value of echocardiogram combined with electrocardiogram QRS in the diagnosis and prognosis of the myocardial infarction. Methods Ninety-seven patients confirmed as acute myocardial infarction in our hospital from Jan. 2014 to Dec. 2014 were selected, which were divided into two groups according to the type of myocardial infarction:61 patients with acute myocardial infarction as the AMI group and 36 patients with old myocardial infarction as the OMI group. With coronary arteriography as the gold standard for diagnosis, echocar-diogram and ECG QRS wave examination, combined with fragmentation of classification, risk stratification and prog-nostic evaluation were used to observe the sensitivity in patients with different types of myocardial infarction in differ-ent stages and its value for evaluating prognosis. Results The accuracy rate of echocardiogram for acute myocardial infarction (AMI) and old myocardial infarction (OMI) were 78.69%and 44.44%, with statistically significant differ-ences between the two groups (P<0.05). According to the examination results, the patients were divided into three groups:the high-risk group, the medium-risk group and the low-risk group. In the high-risk group, patients with multi-vessel disease accounted for 94.12%and the patients with total occlusion accounted for 52.94%, which were signifi-cantly higher than the ratio in the medium-risk group and the low-risk group (P<0.05). In the high-risk group, patients of stageⅢ,ⅣA,ⅣB accounted for 20.59%, 47.06%, 32.35%, and the proportion of patients of stageⅣA,ⅣB were significantly higher than those in the medium-risk group and low-risk group, with statistically significant differences (P<0.05). Conclusion Echocardiogram has higher value in the diagnosis of myocardial infarction, and echocardio-gram combined with electrocardiogram QRS has great significance for determining the degree of infarction and evalu-ating the prognosis.
