[1]廖平群.18导联心电图与多导联动态心电图对以胸痛为主要表现胃食管反流的诊断价值[J].医学信息,2023,36(14):155-158.[doi:10.3969/j.issn.1006-1959.2023.14.033]
　LIAO Ping-qun.The Diagnostic Value of 18-lead Electrocardiogram and Multi-lead Dynamic Electrocardiogram for Gastroesophageal Reflux with Chest Pain as the Main Manifestation[J].Journal of Medical Information,2023,36(14):155-158.[doi:10.3969/j.issn.1006-1959.2023.14.033]
点击复制

18导联心电图与多导联动态心电图对以胸痛为主要表现胃食管反流的诊断价值()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年14期
页码:
155-158
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
The Diagnostic Value of 18-lead Electrocardiogram and Multi-lead Dynamic Electrocardiogram for Gastroesophageal Reflux with Chest Pain as the Main Manifestation
文章编号:
1006-1959（2023）14-0155-04
作者:
廖平群
（吉水县人民医院心血管内科，江西 吉水 331600）
Author(s):
LIAO Ping-qun
(Department of Cardiovascular Medicine,Jishui County People’s Hospital,Jishui 331600,Jiangxi,China)
关键词:
18导联心电图; 多导联动态心电图; 胸痛; 胃食管反流
Keywords:
18-lead electrocardiogram; Multi-lead electrocardiogram; Chest pain; Gastroesophageal reflux
分类号:
R573
DOI:
10.3969/j.issn.1006-1959.2023.14.033
文献标志码:
A
摘要:
目的 研究18导联心电图与多导联动态心电图对以胸痛为主要表现胃食管反流的诊断价值。方法 选取2021年4月-2022年4月我院诊治的62例以胸痛为主要表现胃食管反流患者为研究对象，均行18导联心电图、多导联动态心电图检查，观察不同检查方法检出率、检查时临床症状（胸痛发作、心律失常）发生率、ST波改变（ST段下压＜0.1 mV、ST段下压≥0.1 mV）情况、诊断效能（敏感度、特异度）。结果 多导联动态心电图对以胸痛为主要表现胃食管反流检出率为96.77%，高于18导联心电图的85.48%（P＜0.05）；多导联动态心电图检查时胸痛发作、心律失常发生率均高于18导联心电图检查（P＜0.05）；多导联动态心电图检查ST段下压＜0.1 mV、ST段下压≥0.1 mV发生率均高于18导联心电图检查（P＜0.05）；多导联动态心电图检查诊断以胸痛为主要表现胃食管反流敏感度、特异度均高于18导联心电图检查（P＜0.05）。结论 18导联与多导联动态心电图检查对以胸痛为主要表现的胃食管反流均具有一定的价值，但是多导联动态心电图可提高诊断效能，预防漏诊、误诊，并且可提高检查过程中胸痛发作、心律失常以及ST波改变检出率，可为临床有效治疗提供可靠参考。
Abstract:
Objective To study the diagnostic value of 18-lead electrocardiogram and multi-lead dynamic electrocardiogram in gastroesophageal reflux with chest pain as the main manifestation.Methods From April 2021 to April 2022, 62 patients with gastroesophageal reflux with chest pain as the main manifestation in our hospital were selected as the research objects. All patients underwent 18-lead electrocardiogram and multi-lead dynamic electrocardiogram. The detection rate of different examination methods, the incidence of clinical symptoms (chest pain attack, arrhythmia), ST wave changes (ST segment pressure <0.1 mV, ST segment pressure ≥0.1 mV) and diagnostic efficacy (sensitivity, specificity) were observed.Results The detection rate of gastroesophageal reflux with chest pain as the main manifestation by multi-lead dynamic electrocardiogram was 96.77%, which was higher than 85.48% of 18-lead electrocardiogram (P<0.05). The incidence of chest pain and arrhythmia by multi-lead dynamic electrocardiogram was higher than that by 18-lead electrocardiogram (P<0.05). The incidence of ST segment depression <0.1 mV and ST segment depression ≥0.1 mV by multi-lead dynamic electrocardiogram was higher than that by 18-lead electrocardiogram (P<0.05). The sensitivity and specificity of multi-lead dynamic electrocardiogram in the diagnosis of gastroesophageal reflux with chest pain as the main manifestation were higher than those of 18-lead electrocardiogram (P<0.05).Conclusions Both 18-lead and multi-lead dynamic electrocardiogram have certain value for gastroesophageal reflux with chest pain as the main manifestation, but multi-lead dynamic electrocardiogram can improve the diagnostic efficiency, prevent missed diagnosis and misdiagnosis, and improve the detection rate of chest pain attack, arrhythmia and ST wave change during the examination, which can provide a reliable reference for clinical effective treatment.

参考文献/References:

[1]姚明英.胃肠超声造影法诊断胃肠疾病的临床价值[J].昆明医科大学学报,2015,36(8):126-128.[2]娄迎阁,李亚珂,时贵阁,等.胃肠超声造影诊断胃占位性疾病的临床价值[J].中国临床医学影像杂志,2017,28(8):594-595.[3]卓朝贵.心电图在胃食管反流病和冠心病中的鉴别诊断作用[J].实用诊断与治疗杂志,2007,21(5):372-372,376.[4]邵荣瑢,李阳,葛思堂,等.胃超声造影对胃食管反流解剖学病因的临床诊断价值[J].蚌埠医学院学报,2019,4(1):101-103.[5]喻萍一,谷颖,谢瑾.彩色多普勒胃肠超声造影对胃食管反流病的临床诊断价值[J].贵州医科大学学报,2019,44(8):980-982,986.[6]彭利,王竞宇,郑世成,等.胃充盈超声造影与内镜检查对胃食管反流病的诊断价值[J].西部医学,2019,31(10):1613-1616.[7]胡志伟,田书瑞,吴继敏,等.胃食管反流病的普通胃镜学特点:4086例临床分析[J].解放军医学杂志,2018,43(1):38-44.[8]江春花,林榕.18导联心电图诊断急性正后壁心梗的价值[J].临床心电学杂志,2021,30(4):254-256.[9]穆扎帕尔·木沙.联合诊断方法对胃食管反流病相关非心源性胸痛应用的研究[D].乌鲁木齐:新疆医科大学,2018.[10]杨根妹,张忠兵,姚建芳,等.胃食管反流性胸痛的临床探讨[J].上海医学,2004,27(7):488-490.[11]徐宏薇,徐锦江.动态24 h食管pH监测对胃食管反流患者生活质量的影响[J].锦州医科大学学报,2022,43(4):74-78.[12]袁召.食管源性胸痛患者的食管动力特点及病因分析[D].大连:大连医科大学,2016.[13]张丽娜,马治国,杨少奇,等.食管动力及24 h食管pH测定在食管源性胸痛患者中的临床应用[J].宁夏医学杂志,2019,41(9):833-835.[14]Hachem C,Shaheen NJ.Diagnosis and Management of Functional Heartburn[J].Am J Gastroenterol,2016,111(1):53-61.[15]李德华,王洪涛,李怡.食管近端、远端平均夜间基线阻抗值及反流后吞咽诱发的蠕动波指数对胃灼热的鉴别诊断价值[J].河南医学研究,2020,29(29):5395-5398.[16]王素文,吴丽榕,施荣南,等.动态心电图在以胸痛为主要表现的胃食管反流病鉴别诊断中的应用价值[J].心血管病防治知识,2018(19):51-52.[17]郭晓旭,罗茜,王潇,等.食管基线阻抗值在鉴别胃食管反流病和功能性烧心中的应用[J].胃肠病学和肝病学杂志,2017,26(5):526-530.[18]McConaghy JR,Sharma M,Patel H.Acute Chest Pain in Adults: Outpatient Evaluation[J].Am Fam Physician,2020,102(12):721-727.[19]Kato H,Ishii T,Akimoto T,et al.Prevalence of linked angina and gastroesophageal reflux disease in general practice[J].World J Gastroenterol,2009,15(14):1764-1768.

更新日期/Last Update: 1900-01-01