超声心动图联合心电图QRS碎裂波诊断心肌梗死的价值

摘要

Objective To observe the value of echocardiogram combined with electrocardiogram QRS in the diagnosis and prognosis of the myocardial infarction. Methods Ninety-seven patients confirmed as acute myocardial infarction in our hospital from Jan. 2014 to Dec. 2014 were selected, which were divided into two groups according to the type of myocardial infarction:61 patients with acute myocardial infarction as the AMI group and 36 patients with old myocardial infarction as the OMI group. With coronary arteriography as the gold standard for diagnosis, echocar-diogram and ECG QRS wave examination, combined with fragmentation of classification, risk stratification and prog-nostic evaluation were used to observe the sensitivity in patients with different types of myocardial infarction in differ-ent stages and its value for evaluating prognosis. Results The accuracy rate of echocardiogram for acute myocardial infarction (AMI) and old myocardial infarction (OMI) were 78.69%and 44.44%, with statistically significant differ-ences between the two groups (P<0.05). According to the examination results, the patients were divided into three groups:the high-risk group, the medium-risk group and the low-risk group. In the high-risk group, patients with multi-vessel disease accounted for 94.12%and the patients with total occlusion accounted for 52.94%, which were signifi-cantly higher than the ratio in the medium-risk group and the low-risk group (P<0.05). In the high-risk group, patients of stageⅢ,ⅣA,ⅣB accounted for 20.59%, 47.06%, 32.35%, and the proportion of patients of stageⅣA,ⅣB were significantly higher than those in the medium-risk group and low-risk group, with statistically significant differences (P<0.05). Conclusion Echocardiogram has higher value in the diagnosis of myocardial infarction, and echocardio-gram combined with electrocardiogram QRS has great significance for determining the degree of infarction and evalu-ating the prognosis.%目的：观察超声心动图联合心电图QRS碎裂波在心肌梗塞诊断和预后评估中的应用价值。方法选择我院2014年1~12月确诊的心肌梗塞患者97例，根据心肌梗塞类型分为两组，其中急性心肌梗塞(AMI)61例，设为AMI组；陈旧性心肌梗塞(OMI)36例，设为OMI组，以冠状动脉造影术诊断结果为“金标准”，对超声心动图及联合心电图QRS碎裂波检查、分类、危险分层及预后评价情况进行分析，观察其在不同阶段、不同类型心肌梗死患者中的敏感性和预后评估价值。结果超声心动图对AMI和OMI的诊断准确率分别为78.69%和44.44%，AMI组的准确率明显高于OMI组，两组比较差异具有统计学意义(P<0.05)。根据检查结果将患者分为三组，高危组患者多支血管病变者占94.12%，52.94%的患者完全闭塞，构成比明显高于中危组和低危组，差异均具有统计学意义(P<0.05)。高危组Ⅲ级、ⅣA级、ⅣB级患者的构成比分别为20.59%、47.06%、32.35%，ⅣA级、ⅣB级患者的比例明显高于中危组和低危组，差异具有统计学意义(P<0.05)。结论超声心动图对心肌梗塞具有较高的诊断价值，两项指标联合检测对梗塞程度的确定、预后的评估具有一定的意义。