Lorenz散点图对老年冠心病伴房颤患者的诊断价值

摘要/Abstract

摘要： 目的探讨Lorenz散点图对冠心病伴房颤老年患者的诊断价值。方法选择2019年6月—2022年6月在内蒙古自治区人民医院诊治的102例冠心病老年患者作为研究对象,所有患者都给予心电图检查,记录传统心电图指标与Lorenz散点图指标。以临床最终诊断作为金标准,判断散点图的诊断敏感性与特异性。结果在102例患者中,最终临床诊断为房颤42例（房颤组),占41.18%。房颤组的心率、收缩压、身体质量指数、舒张压、性别、年龄等与非房颤组比较,差异无统计学意义（P>0.05）。房颤组的QRS、QTs与非房颤组比较,差异无统计学意义（P>0.05）。房颤组的P波时限、P波振幅都显著高于非房颤组,差异有统计学意义（P<0.05）。房颤组与非房颤组的P波离散度、P波指数比较,差异无统计学意义（P>0.05）。房颤组的Lorenz散点图的长轴、短轴都低于非房颤组,矢量角度指数、矢量长度指数明显高于非房颤组,差异有统计学意义（P<0.05）。在102例患者中,散点图判断为房颤41例,散点图对冠心病伴房颤老年患者的诊断敏感性与特异性分别为92.86%和96.67%。ROC曲线显示,Lorenz散点图对冠心病伴房颤老年患者的诊断曲线下面积为0.951。结论依靠传统心电图指标很难有效鉴别冠心病并发房颤情况,Lorenz散点图对冠心病伴房颤老年患者的诊断具有很高的敏感性与特异性,值得临床应用。

关键词: Lorenz散点图, 老年人, 冠心病, 房颤, 敏感性, 24小时动态心电图, 矢量长度指数

Abstract: Objective To explore the diagnostic values of Lorenz scatter plot in elderly patients with coronary heart disease and atrial fibrillation. Methods 102 cases of elderly patients with coronary heart disease who were diagnosed and treated in our hospital from June 2019 to June 2022 were selected as the study subjects. All patients were subjected to electrocardiographic examination, recorded the traditional electrocardiographic indicators and Lorenz scatter plot indicators in the all cases. Used the final clinical diagnosis as the gold standard, determined the diagnostic sensitivity and specificity of the electrocardiographic scatter plot. Results There were 42 cases (41.18%) were clinically diagnosed as atrial fibrillation in the 102 cases. There were no significant differences in heart rate, systolic blood pressure, body mass index, diastolic blood pressure, gender, and age compared between the atrial fibrillation group and the non atrial fibrillation group (P>0.05). There was no significant difference in QRS and QTs between the atrial fibrillation group and the non atrial fibrillation group (P>0.05). The P wave time limit and P wave amplitude were significantly higher than the non-AF group (P<0.05), and there was no significant difference between P wave dispersion and P wave index between AF group and non-AF group (P>0.05). The long axis and short axis of Lorenz scatter plot in atrial fibrillation group were lower than those in non atrial fibrillation group, and the vector angle index and vector length index were significantly increased compared with non atrial fibrillation group (P<0.05). In the 102 patients, there were 41 cases were diagnosed as atrial fibrillation by scatter plot. The sensitivity and specificity of scatter plot in the diagnosis of elderly patients with coronary heart disease and atrial fibrillation were 92.86%and 96.67%, respectively. The ROC curve shows that the area under the diagnostic curve of Lorenz scatter plot for elderly patients with coronary heart disease and atrial fibrillation were 0.951. Conclusion It is difficult to effectively distinguish between coronary heart disease and atrial fibrillation by relying on traditional electrocardiogram indicators. Scatter plots have high sensitivity and specificity in the diagnosis of elderly patients with coronary heart disease and atrial fibrillation, and are worthy of clinical promotion and application.

Key words: lorenz scatter chart, aged, coronary heart disease, atrial fibrillation, sensitivity, 24 hour ambulatory electrocardiogram, vector length index

中图分类号:

R541.4

丁琳. Lorenz散点图对老年冠心病伴房颤患者的诊断价值[J]. 中华养生保健, 2023, 41(21): 53-56.

DING Lin. Diagnostic Value of Lorenz Scatter Plot in Elderly Patients with Coronary Heart Disease and Atrial Fibrillation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(21): 53-56.

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