动态心电图联合心率变异参数定量在诊断心电图ST-T改变中的价值

摘要/Abstract

摘要： 目的探究动态心电图联合心率变异参数在诊断心电图ST-T改变中的应用价值。方法选择2020年7月—2023年4月于陕西省森林工业职工医院接受体格检查的170人作为研究对象,对入组研究对象均开展心电图检查,按照其检测结果是否存在ST-T改变分为研究组（n=85,存在心电图ST-T改变）和对照组（n=85,无心电图ST-T改变）,分别对两组实施动态心电图检测,记录其心率变异性中定量参数相邻NN间期差值>50 ms研究对象所占的百分比（PNN50）、相邻NN间期差值的均方根（RMSSD）、所有窦性心律RR间期标准差（SDNN）后进行比较,通过绘制ROC曲线的方式判断动态心电图、心率变异定量参数以及联合检测对心电图ST-T诊断的价值。结果研究组动态心电图中的室上早及室上速均显著高于对照组,差异有统计学意义（P<0.05）;动态心电图指标室上早和室上速对心电图ST-T改变的诊断AUC分别为0.873、0.856,诊断灵敏度为81.18%,特异度为76.65%,提示数据的一致性良好;研究组心率变异参数中的SDNN、RMSSD以及PNN50均显著高于对照组,差异有统计学意义（P<0.05）;心率变异参数SDNN、RMSSD以及PNN50对心电图ST-T改变的诊断AUC分别为0.845、0.622、0.799,诊断灵敏度为83.53%、61.18%、74.12%,特异度为81.18%、52.95%、70.59%,提示SDNN、PNN50对心电图ST-T改变的诊断的一致性良好,而RMSSD有较低的一致性;采用串联方式,计算显示,动态心电图联合心率变异参数对心电图ST-T改变诊断的一致性为95.88%,灵敏度为98.82%,特异度为92.94%。结论心电图ST-T改变患者的动态心电图参数及心率变异参数均会出现明显改变,将上述定量参数应用于心电图ST-T改变诊断中存在较好的临床效能,具有一定的临床应用价值。

关键词: 动态心电图, 心率变异参数, 心电图ST-T改变, 诊断效能

Abstract: Objective To explore the application value of Holter monitor combined with heart rate variability parameters in the diagnosis of ECG ST-T changes. Methods Chose 170 individuals who underwent physical examinations at Shaanxi Forest Industry Employee Hospital from July 2020 to April 2023 were selected as the research subjects. All enrolled individuals underwent electrocardiogram examinations, and were divided into the study group (n=85, with electrocardiogram ST-T changes) and the control group (n=85, without electrocardiogram ST-T changes) based on their test results. Dynamic electrocardiogram tests were performed on both groups of individuals, Record the percentage of quantitative parameters with a difference between adjacent NN intervals>50 ms in heart rate variability (PNN50), the root mean square (RMSSD) of the difference between adjacent NN intervals, and the standard deviation (SDNN) of all sinus rhythm RR intervals for comparison. Calculate the diagnostic value of dynamic electrocardiogram, quantitative parameters of heart rate variability, and combined detection for electrocardiogram ST-T by plotting ROC curves. Results The supraventricular premature beats and supraventricular tachycardia in Holter monitor of patients in the study group were significantly higher than those in the control group (P<0.05). The AUC of Holter monitor index for diagnosis of ST-T changes in electrocardiogram was 0.873 and 0.856, the consistency of the prompt data is good. The SDNN, RMSSD, and PNN50 of heart rate variability parameters in the study group were significantly higher than those in the control group (P<0.05). The diagnostic AUC of heart rate variability parameters SDNN, RMSSD, and PNN50 for ST-T changes in electrocardiogram were 0.845,0.622 and 0.799, suggesting that SDNN and PNN 50 showed good agreement in the diagnosis of ECG ST-T changes, while RMSSD had low agreement.By using a series connection method, the diagnostic consistency, sensitivity,and specificity of the combination of dynamic electrocardiogram and heart rate variability parameters for ST-T changes in electrocardiogram were 95.88%,98.82% and 92.94%. Conclusion The Holter monitor parameters and heart rate variability parameters of patients with ECG ST-T changes will change significantly. The application of the above quantitative parameters in the diagnosis of ECG ST-T changes has good clinical efficacy, and has a certain value of popularization and application.

Key words: holter monitor, heart rate variability parameters, changes in electrocardiogram ST-T, diagnostic effectiveness

中图分类号:

R541.4

李琴. 动态心电图联合心率变异参数定量在诊断心电图ST-T改变中的价值[J]. 中华养生保健, 2024, 42(16): 186-188.

LI Qin. The Value of Holter Monitor Combined with Heart Rate Variability Parameters in the Diagnosis of ECG ST-T Changes[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(16): 186-188.

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