目的 探讨运用心电散点图分析动态心电图伪差的意义.方法 选择多种典型的动态心电图伪差病例,利用心电散点图及逆向技术,分析并总结其心电散点图特征.结果 伪差的产生遵守一定的"识别"模式或"数学"特性,从而产生具有一定规则分布的图形的心电散点图图形,可表现为关于45°线对称、平行、垂直等形式.结论 通过心电散点图可以快速发现和定位伪差点集,并结合逆向技术确定伪差性质而进行针对性处理,提高诊断效率.

目的 研究12导联动态心电图在冠心病心肌缺血诊断及鉴别诊断中的应用价值.方法 回顾性分析2019年1月-2020年1月在清远市人民医院就诊的80例冠心病患者心电图资料,所有患者均接受12导联常规心电图检查和12导联动态心电图,以冠状动脉造影诊断结果为金标准,分析比较两种心电图对心肌缺血的诊断及鉴别诊断价值.结果 12导联动态心电图检查冠心病心肌缺血阳性率明显高于12导联常规心电图检查(P<0.05);以冠状动脉造影诊断结果为金标准,12导联动态心电图诊断冠心病心肌缺血的灵敏度、阴性预测值、准确率、kappa值均高于12导联常规心电图;不稳定型心绞痛的正常窦性R-R间期的总体标准差(SDNN)[(85.25±8.33)ms]明显低于稳定型心绞痛[(101.21±10.39)ms,P<0.05],受试者工作曲线(ROC)曲线分析,以SDNN等于90ms为诊断截点值,SDNN诊断不稳定型心绞痛的敏感性为83.21％,特异性为74.86％,曲线下面积为0.85.结论 12导联动态心电图对冠心病心肌缺血具有较高的诊断价值,且对不同类型心肌缺血具有鉴别诊断价值.

目的:分析心肌梗死ST段抬高患者发生室壁瘤的临床危险因素.方法:以2016年1月～ 2021年3月500例心肌梗死ST段抬高患者为临床研究对象,其中发生室壁瘤的患者65例为观察组,未发生室壁瘤的患者435例为对照组.通过多因素Logistic回归分析对影响室壁瘤发生的因素进行分析,研究分析造成室壁瘤发生的高危因素.结果:术后BNP＞100 ng/L、术后ST段回落率(≥50％)、罪犯血管为LAD/LM、既往心绞痛史是影响室壁瘤发生的主要因素(P＜0.05).结论:心肌梗死ST段抬高患者室壁瘤发生率较高,考虑与术后hs-CRP超过8mg/L、术后ST段回落率(≥50％)、罪犯血管LAD/LM、既往心绞痛史等因素有关.

目的 分析心脏彩超在高血压左心室肥厚伴左心衰竭患者中的诊断价值.方法 选择我院收治的高血压左心室肥厚伴左心衰竭患者160例作为观察组,同期健康者160例作为对照组.两组均接受心脏彩超检查,比较两组的收缩压 (SBP)、舒张压 (DBP)、左室射血分数 (LVEF)、左室收缩末期内径 (LVESD)、左室舒张末期内径 (LVEDD); 比较观察组不同心功能等级患者的心脏相关指标.结果 观察组的SBP、 DBP高于对照组,LVEF低于对照组,LVESD、 LVEDD高于对照组,组间有显著性差异 (P＜0.01).观察组患者中,心功能等级越高,LVEF越低,LVESD和LVEDD越高.结论 高血压左心室肥厚伴左心衰竭患者的心脏功能存在不同程度的变化,心脏彩超可作为诊断该病的有效工具,值得在临床中推广应用.

患者男性,71岁,因心悸、胸闷就诊.行24 h动态心电图检查,前段散点图呈"棒球拍"与"曲尺状"组合,诊断为:窦性心动过缓并交界性逸搏或交界性自主节律;后段散点图与前段完全不同,呈特殊的4分布,诊断为:窦性心动过缓并交界性自主节律、等频性房室分离,窦性夺获伴交界性节律重整.本例患者前后心电图诊断虽基本一致,但是由于不同条件下发生不同的节律机制,导致形成了完全不同的心电散点图特征.

Objective To investigate the relationship between hsCRP, apoB/apoA1, blood lipid expression and acute coronary syndrome (ACS) in premature coronary heart disease. Methods A total of 110 patients with acute coronary syndrome with premature coronary heart disease admitted to Qingyuan People's Hospital from February 2014 to February 2018 were enrolled in the observation group. Another 118 patients with non-coronary heart disease who were hospitalized for chest pain at the same time but were confirmed to be coronary artery lesions negative by coronary angiography were selected as the control group. The general data of the two groups of patients were counted and the fasting elbow vein blood was taken. Apolipoprotein A1 (apoA1), apolipoprotein B (apoB), high-sensitivity C-reactive protein (hsCRP) and blood glucose (GLU), total cholesterol (TC), triglyceride (TG) by automatic biochemical analyzer High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), uric acid (UA), and serum creatinine (Scr) levels were measured. Multivariate logistic regression analysis was used to analyze the independent influencing factors of acute coronary syndrome in patients with premature coronary heart disease. The relationship between hsCRP, apoB/apoA1, blood lipid expression and acute coronary syndrome of early onset coronary heart disease was analyzed. Results There was no significant difference in the proportion of age, body mass index (BMI), UA and diabetes history between the two groups (P>0.05). The proportion of males, smoking history, drinking history, family history of coronary heart disease and hypertension history in the observation group was significantly higher than that in the control group (P<0.05), and the levels of Scr and GLU were significantly higher than those in the control group (P<0.05). There was no significant difference in the levels of LDL-C and apoB between the two groups (P>0.05). The levels of serum hsCRP, TC, TG, non-HDL-C and apoB/apoA1 in the observation group were significantly higher than those in the control group (P<0.05), and the levels of apoA1 and HDL-C were significantly lower than those in the control group (P<0.05). Multivariate logistic regression analysis showed that in addition to male, smoking history, and family history of coronary heart disease, hsCRP, TG, HDL-C, non-HDL-C, apoA1, and apoB/apoA1 were all early coronary heart disease acute coronary syndromes. Independent influence factors (P<0.05). Conclusion hsCRP, TG, non-HDL-C, apoB/apoA1 were significantly elevated in peripheral blood of patients with early-onset coronary heart disease and acute coronary syndrome. ApoA1 and HDL-C were significantly decreased in peripheral blood and could be used as predictors.

目的:探究急性冠脉综合征(ACS)介入术后心电图变化与生存质量的相关性.方法:研究对象为某院2016年12月～2017年12月收治的80例ACS介入术后的患者,于术前及术后1h、24h记录心电图,按术后1h ST段回落是否≥50％ 和24h T波是否倒置各分为4组,术后1h ST段回落≥50％ 的有19例,<50％ 的有22例,术后24h T波倒置的有24例,未倒置的有15例.探讨介入治疗后心电图ST段和T波演变与预后的关系.结果:ST段回落≥50％ 组1个月、6个月时在左室射血分数(LVEF)上与ST段回落<50％ 组相比显著较高(P<0.05);而T波倒置组1个月、6个月时在LVEF上与T波未倒置组相比显著较高(P<0.05);4组在1个月时的左心室舒张末期内径(LVD)上无显著差异(P>0.05),而在6个月时ST段回落≥50％ 组显著比ST段回落<50％ 组低(P<0.05),T波倒置组显著比T波未倒置组低(P<0.05);在术后1个月及6个月SF-36评分上,ST段回落≥50％ 组显著比ST段回落<50％ 组高(P<0.05),T波倒置组显著比T波未倒置组高(P<0.05).结论:心电图演变是反映心脏血管的指标,临床可根据ACS介入术后心电图变化来判断患者心功能情况,PCI术后ST段早期回落及T波倒置的患者预后较好,生存质量高,该方法值得应用与推广.

目的 观察冠心病合并代谢综合征(MS)患者血清载脂蛋白B、A1及其比值与冠状动脉病变特点.方法 选取2016年9月-2017年11月行冠状动脉造影并确诊为冠心病的患者214例,其中合并MS患者94例(MS组),不合并MS患者120例(非MS组).MS组根据病变支数分为单支病变亚组和多支病变亚组,分析血清载脂蛋白(Apo)B和ApoA1及ApoB/ApoA1与冠状动脉病变程度的关系.结果 MS组与非MS组高血压、TG、HDL-C、ApoA1、ApoB水平及ApoB/ApoA1比较差异均有统计学意义(P<0.05);MS组多支病变亚组ApoB水平高于单支病变亚组,ApoA1及ApoB/ApoA1比较差异无统计学意义(P>0.05).结论 血清ApoB水平与冠状动脉病变程度呈正相关,是评价MS的良好参数.

目的 探讨NT-proBNP和hs-CRP对急性冠脉综合征诊断价值情况.方法 分析我院2014年3月～2018年3月收治的急性冠脉综合征患者265例,同时选取同期来我院健康体检者200例作为对照组.观察两组研究对象血浆N末端脑钠肽(NT-proBNP)和超敏C-反应蛋白(hs-CRP)变化情况,观察急性冠脉综合征患者不同病变NT-proBNP和hs-CRP变化情况,观察急性冠脉综合征不同预后和NT-proBNP、hs-CRP比较情况.结果 急性冠脉综合征组NT-proBNP和hs-CRP均高于对照组,双支病变组、3支病变组患者NT-proBNP和hs-CRP均高于单支病变组,3支病变组患者NT-proBNP和hs-CRP均高于双支病变组,发生不良心血管事件组NT-proBNP、hs-CRP均高于未发生不良心血管事件组,差异有统计学意义(P<0.05).结论 NT-proBNP和hs-CRP水平对于急性冠脉综合征预后有很高的预测价值,加强N T-proBNP、hs-CRP监测,可以降低不良预后发生率.

目的 着重探讨非糖尿病急性冠脉综合征患者apoB/apoA1和BMI的水平变化及其与急性冠脉综合征发病风险的相关性.方法 收集2014年3月至2016年6月于清远市人民医院心血管内科住院行冠脉造影术符合急性冠脉综合征诊断标准并无糖尿病的患者109例为研究对象,另外收集同期本院健康体检中心排除冠心病及糖尿病的健康体检者97例为对照.登记所有研究对象的临床资料性别、年龄、BMI、既往病史等临床资料,次日清晨空腹采集血样.结果 与对照组比较,非糖尿病急性冠脉综合征患者BMI、血清apoB/apoA1显著增高.BMI、吸烟史、冠心病家族史、apoB/apoA1与非糖尿病急性冠脉综合征呈正相关(P＜0.05).结论 BMI、apoB/apoA1可能是非糖尿病急性冠脉综合征发病风险的危险因素,减轻体重和调脂治疗是预防冠心病或减慢冠心病患者冠状动脉粥样硬化进展的重要措施.

目的：研究早发冠心病急性冠脉综合征患者血清hsCRP与apoB／apoA1水平及相关性分析，探讨血清apoB／apoA1与炎性因子hsCRP对早发冠心病急性冠脉综合征患者的影响。方法搜集2014年3月至2015年6月因胸痛于清远市人民医院心血管内科住院行冠脉造影术符合急性冠脉综合征诊断标准的患者，年龄：男性≤55岁，女性≤65岁共114例为早发冠心病急性冠脉综合征组，另外搜集同期我院健康体检中心排除冠心病史的健康体检者，年龄：男性≤55岁，女性≤65岁，共122例为健康体检组。所有患者均抽取空腹外周静脉血并分离血清，所有项目应用日立全自动生化仪完成。结果（1）对比健康体检组，早发冠心病急性冠脉综合征组HDL-C、apoA1水平显著降低，hsCRP、apoB／apoA1水平显著升高，差异有统计学意义（P均＜0．05）。（2）多重线性回归分析显示，早发冠心病急性冠脉综合征组HSCRP与HDL、apoA1、呈负相关，与 apoB／apoA1呈正相关（ P ＜0．05）。结论 HDL-C、apoA1、hsCRP、apoB／apoA1水平对早发冠心病急性冠脉综合征患者具有敏感的预测价值。 apoA1、apoB／apoA1水平与机体炎症反应的相互关系可能为早发冠心病急性冠脉综合征患者发病的重要机制。

Many advantages of iapd makes it as a kind of modern equipment is introduced to the medical profession,to medical equip-ment,particularly portable health care equipment manufacturers,Apple iPad portable performance design bril iance,has become a trend.In this pa-per,the current ECG processing technology,through the Bluetooth connection to the iapd platform,designed to facilitate the intel igent wireless ECG machine,convenient for ECG examination.

Objective:To investigate the electrocardiogram(ECG) features of pregnant women.Methods:With Brentwood electrocardiograph,the ECG examination was performed in 170 pregnant women and 170 healthy women,and their results were compared.Results:The ECG abnormality in pregnant woman group was found in 82 cases,in which the short P-R period was 16 cases,arrhythmia 42 cases(including sinus tachycardia 30 cases,atrial extrasystole 8 cases and ventricular extrasystole 4 cases) as well as ST-T variety 24 cases.Conclusion:The ECG abnormality in pregnant woman is significantly higher than that in healthy woman,especially arrhythrnia.

对190例TV1＞V5(V6)、无临床表现者(有明显的性别差异)进行活动平板试验,分40岁以上为(A组)和40岁以下为(B组)两组,试验结果阳性者100例,占总数的53%;特别是40岁以上年龄组阳性率达66%.本结果提示,TV1＞V5(V6)是一种异常现象,宜作活动平板检查.