| 动态心电图及脑钠尿肽诊断冠心病无症状性心肌缺血的价值 |
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| 引用本文： | 信丽,沈杰.动态心电图及脑钠尿肽诊断冠心病无症状性心肌缺血的价值[J].心脏杂志,2019,30(1):54-56. |
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| 作者姓名： | 信丽 沈杰 |
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| 作者单位： | 合肥京东方医院心功能科;解放军第901医院心电图室 |
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| 摘 要： | 目的 评价动态心电图（DCG）及脑钠尿肽（BNP）诊断冠心病无症状性心肌缺血的价值。 方法 住院冠心病患者69例，所有患者均进行常规心电图（ECG）、DCG检查以及血浆BNP检测，并以冠状动脉造影的检查结果为标准，比较不同诊断方法对冠心病无症状性心肌缺血的诊断情况，并对冠心病并发无症状性心肌缺血和有症状心肌缺血患者的ST段位移情况进行比较。 结果 各诊断方法比较，DCG的灵敏度、特异度、准确度均高于BNP，且DCG的准确度高于ECG（P<0.05，P<0.01），均存在统计学差异；DCG联合BNP（平行试验）检测的诊断敏感度既高于DCG，也高于BNP，特异度低于DCG诊断，准确度高于ECG和BNP诊断（P<0.05，P<0.01）；经过DCG的检查后结果显示，冠心病并发无症状性心肌缺血患者的ST段位移情况均显著多于有症状性心肌缺血患者（P<0.05）。 结论 DCG对冠心病并发无症状性心肌缺血的诊断较BNP诊断更为灵敏，BNP也可以作筛选指标，并可辅助DCG进行诊断。
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| 关 键 词： | 动态心电图 脑钠尿肽 冠状动脉疾病 无症状性心肌缺血 |
| 收稿时间： | 2017-10-25 |
Diagnostic value of dynamic electrocardiogram and BNP in asymptomatic myocardial ischemia of coronary heart disease |
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| Abstract: | AIM AIM To evaluate the value of dynamic electrocardiogram and BNP in the diagnosis of asymptomatic myocardial ischemia in patients with coronary heart disease. METHODS Between June 2014 to May 2017, 69 patients with coronary heart disease were enrolled in this study. All patients underwent routine electrocardiogram, ambulatory electrocardiogram, and plasma brain natriuretic peptide (BNP) measurement. The diagnosis of asymptomatic myocardial ischemia was compared between different diagnostic methods and the ST segment displacement of patients with coronary heart disease complicated with asymptomatic myocardial ischemia and symptomatic myocardial ischemia were compared. RESULS Sensitivity, specificity, and accuracy of DCG were higher than those of BNP, and the accuracy of DCG was higher than that of ECG, P<0.05, with statistical differences. The diagnostic sensitivity of dynamic electrocardiogram combined with BNP detection was higher than other diagnostic schemes, specificity was lower than that of DCG diagnosis, and accuracy was higher than ECG and BNP diagnosis (P<0.05,P<0.01), with statistical differences. The results revealed that ST segment displacement in patients with symptomatic myocardial ischemia was significantly higher than that in patients with symptomatic myocardial ischemia (P<0.05). There were significant differences. CONCLUSION Dynamic electrocardiogram is more sensitive to the diagnosis of coronary heart disease with asymptomatic myocardial ischemia. It can be used to distinguish patients with symptomatic and asymptomatic myocardial ischemia. BNP can also be used as coronary heart disease with asymptomatic myocardial ischemia screening of biochemical indicators, assisted dynamic electrocardiogram diagnosis. |
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