临床误诊误治2017，Vol.30Issue(11)：55-59,5.DOI:10.3969/j.issn.1002-3429.2017.11.018
心电图联合超声心动图检查对不同程度冠心病心力衰竭患者的临床诊断价值
Value of Electrocardiogram Combined with Echocardiography in Diagnosis of Different Degrees of Coronary Heart Disease Patient with Heart Failure
摘要
Abstract
Objective To investigate value of electrocardiogram combined with echocardiography in diagnosis of differ-ent degrees of coronary heart disease patients with heart failure. Methods A total of 214 coronary heart disease patients with heart failure admitted during March 2013 and September 2015 were recruited in this study, who had inclusion and exclusion standard, and the patients were divided into group A (n=48, LEVF< 30%), group B (n=74, 30% <LEVF<40%) and group C (n=92, 40%-49% of LEVF) according to left ventricular ejection fraction (LVEF) scores. In three groups, levels of left ventricular end-diastolic dimension (LVEDD) left atrial diameter (LA) during echocardiographic test, and voltage, limit values of QRS and QTc interval value during electrocardiogram detection were observed and compared, and abnormal echocardio-graphic types and prognoses were analyzed and compared. Results There were significant differences in LVEDD, LA, voltage and limit values of QRS, QTc interval value, and incidence rates of sinus tachycardia, atrial premature beat, ventricular prema-ture beat, ST-T segment change, QT interval prolongation, atrial fibrillation, abnormal Q wave and left anterior branch block (P<0. 05). In the three groups, LVEDD and LA levels were gradually increased; QRS voltage values were gradually de-creased;QRS limit and QTc interval values were gradually increased with aggravating heart failure degree in patients with coro-nary heart disease, and the differences in each index between every two groups were statistically significant (P<0. 05). Inci-dence rates of sinus tachycardia, atrial premature beat, ventricular premature beat, ST-T segment change, QT interval prolonga-tion, atrial fibrillation, abnormal Q wave and left anterior branch block were significantly higher in group A than those in group B and C (P<0. 05). Among the 214 patients, 16 patients were death, and the death time was at 1st)-31rd d after admission, and there were 12 cases in group A, 3 cases in group B and 1 cases in group C. Conclusion LVEDD and LA levels can be found gradually increased, and QRS voltage values can be found gradually decreased, and QRS limit and QTc interval values can be found gradually increased with aggravating heart failure degree in patients with coronary heart disease. Echocardiography com-bined with electrocardiogram is helpful in clinical diagnosis of coronary heart disease patients with heart failure, and clinicians may evaluate patient's condition by change of LVEDD, LA, QRS voltage value, QRS limit and QTc interval changes.关键词
冠心病/心力衰竭/心电描记术/超声心动描记术Key words
Coronary disease/Heart failure/Electrocardiography/Echocardiography分类
医药卫生引用本文复制引用
赵兰蒂,代世昌,杨建彬,钟厚科..心电图联合超声心动图检查对不同程度冠心病心力衰竭患者的临床诊断价值[J].临床误诊误治,2017,30(11):55-59,5.基金项目
河北省科技计划项目(152777185) （152777185）
