心电图不同标准对合并LBBB急性心梗的诊断价值

Diagnostic value of different ECG criteria for acute myocardial infarction complicated with LBBB

刘童铭 ¹韩冰洁 ¹肖芽¹

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作者信息

1. 浙江大学医学院附属邵逸夫医院心电图室浙江杭州 310000
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摘要

目的:探讨心电图3种不同标准对合并LBBB的急性心梗的诊断价值.方法:回顾性研究方式收集医院收治的LBBB患者资料,将合并LBBB急性心肌梗死患者纳入梗死组(77例),将单纯LBBB患者纳入对照组(50例).分别采用巴塞罗那标准、Sgarbossa标准、Smith修订标准诊断合并LBBB急性心肌梗死,并分析诊断效能.结果:与Sgarbossa标准、Smith修订标准比较,巴塞罗那标准对急性心肌梗死进行诊断的SEN、NPV、ACC均更高(P<0.05);巴塞罗那标准诊断急性心肌梗死的SPE分别与采用Sgarbossa≥3分、Sgarbossa≥2分诊断标准进行比较差异有统计学意义(P<0.01);巴塞罗那标准诊断急性心肌梗死的PPV与采用Sgarbossa≥2分诊断标准进行比较差异有统计学意义(P<0.01);ROC曲线显示,与其他诊断标准进行比较,采用巴塞罗那标准对急性心肌梗死诊断的AUC更高(AUC=0.936,P<0.05).进一步采用上述心电图3种不同诊断标准对急性心肌梗死不同部位进行比较,Sgarbossa≥3分(Ⅰ)、Sgarbossa≥2分(Ⅱ)对心梗组患者下壁、侧壁、后壁部位进行诊断后,SEN、NPV均更高,而对前壁、前间壁部位进行诊断,采用巴塞罗那诊断标准进行诊断具有较高的SEN、NPV,但是对心梗组各部位采用Smith Ⅲ、Smith Ⅳ、Smith Ⅴ诊断标准诊断的SEN低,但NPV高.结论:与Sgarbossa标准、Smith修订标准比较,巴塞罗那标准对合并LBBB的急性心肌梗死具有较高诊断效能.

Abstract

Objective:To investigate the diagnostic value of 3 different ECG criteria in acute myocardial infarction complicated with LBBB. Methods: The data of patients in our hospital from January 2020 to January 2023 were collected retrospectively. 77 patients with acute myocardial infarction complicated with LBBB were included in the infarction group, and 50 patients with LBBB alone were included in the control group. Barcelona criteria, Sgarbossa criteria and Smith revised criteria were used to diagnose acute myocardial infarction complicated with LBBB, and the diagnostic efficacy was analyzed. Results: Compared with Sgarbossa standard and Smith revised standard, the SEN, NPV and ACC of Barcelona standard were higher in the diagnosis of acute myocardial infarction (P<0.05). There were significant differences between SPES using Barcelona criteria for the diagnosis of acute myocardial infarction and those using Sgarbossa≥3 score and Sgarbossa≥2 score (P<0.01). There was significant difference between PPV of Barcelona and Sgarbossa≥2 in the diagnosis of acute myocardial infarction (P<0.01). ROC curve showed that compared with other diagnostic criteria, the AUC of Barcelona criteria for the diagnosis of AMI was higher (AUC=0.936, P<0.05). The above three different ECG diagnostic criteria were further used to compare different parts of AMI. After Sgarbossa≥3 points (Ⅰ) and Sgarbossa≥2 points (Ⅱ) were used to diagnose the lower, lateral and posterior walls of patients in MI group, both SEN and NPV were higher, while the anterior and anterior interfacial walls were diagnosed. The SEN and NPV were higher in patients diagnosed with Barcelona diagnostic criteria, but the SEN and NPV were lower in patients diagnosed with Smith Ⅲ, Smith Ⅳ and Smith Ⅴ diagnostic criteria in patients with MI. Conclusion: Compared with Sgarbossa criteria and Smith revised criteria, Barcelona criteria has higher diagnostic efficacy for acute myocardial infarction complicated with LBBB.

关键词

LBBB/急性心肌梗死/心电图/巴塞罗那标准/Sgarbossa标准/Smith修订标准

Key words

LBBB/acute myocardial infarction/electrocardiogram/barcelona standard/sgarbossa standard/smith revised standard

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出版年

2024

安徽医专学报

安徽医学高等专科学校

安徽医专学报

影响因子：0.441

ISSN：2097-0196

参考文献量10

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