心电图在肺栓塞危险分层评估中的应用

陈小凤; 张劲松; 李琳

doi:10.13201/j.issn.1009-5918.2012.03.009

心电图在肺栓塞危险分层评估中的应用

- 南京医科大学第一附属医院急诊科(南京, 210029)

详细信息

通讯作者: 张劲松,E-mail:ZhangJSO@sina.com

中图分类号: R540.4

收稿日期: 2012-01-15

Clinical value of the electrocardiogram in evaluating the risk stratification of pulmonary embolism

- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

More Information

Corresponding author: ZHANG Jinsong, E-mail: ZhangJSO@sina.com

Received Date: 15 January 2012

摘要

摘要: 目的：探讨心电图（ECG）和21-Daniel ECG评分在肺血栓栓塞症（PTE）危险分层评估中的应用价值。方法：选择2005-01-2009-07南京医科大学第一附属医院收治的251例确诊的PTE患者。根据PTE的危险分层标准分为高危、中危、低危3组。分析251例患者入院48 h内的标准12导联ECG，按照Daniel ECG评分系统计算得分。考察3组间ECG波形改变及Daniel ECG评分的差异，并使用ROC曲线评估 Daniel ECG分值预测高危PTE、中高危PTE的准确性。结果：251例PTE患者中ECG出现异常者占82.9%，其中最多见为胸前导联T波倒置。Daniel ECG评分中位数为3分。与低危组相比，高危组与中危组PTE的ECG评分均显著增高。在ROC曲线分析中，Daniel ECG分值预测高危PTE和中高危PTE的准确性的曲线下面积分别为0.721和0.837。取Daniel ECG分值为3.5分时，预测高危PTE的灵敏度、特异度、阳性预测值、阴性预测值分别为68.6%、62%、19.4%、92.9%；预测中高危PTE的灵敏度、特异度、阳性预测值、阴性预测值分别为69%、86.1%、74.1%、76.8%。结论：Daniel ECG评分对中高危PTE有较好的预测价值；Daniel ECG分值<3.5分时对高危PTE有较高的排除诊断价值。
- 肺血栓栓塞症 /
- Daniel ECG评分系统 /
- 危险分层
Abstract: Objective: To study the clinical value of electrocardiogram (ECG) in evaluating the risk stratification of pulmonary embolism.Method: 251 patients with diagnosed PTE in The First Affiliated Hospital of Nanjing Medical University were enrolled in this study from January 2005 to July 2009. The patients were grouped into high-risk, intermediate-risk and low-risk groups according to the risk stratification standard of PTE. The 12-lead ECGs within the beginning 48 hours were analyzed and the scores were calculated according to the 21-Daniel ECG scoring system. The differences of ECG waveform change and Daniel ECG scores of the patients in three groups were studied. Then, the accuracy of ECG score in predicting high-risk PTE,intermediate and high-risk PTE were evaluated though receiver operator characteristic (ROC) curve. Conclusion: The current 21-ECG scoring system can predict intermediate and high-risk PTE well. When the score is less than 3.5 points, Daniel ECG scores can also predict well in excluding high-risk PTE.
- pulmonary thromboembolism /
- daniel ECG scoring system /
- risk stratification

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