动态心电图用于小儿川崎病合并冠状动脉损伤的诊断意义

doi:10.3969/j.issn.1001-8131.2025.01.010

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摘要目的探究动态心电图（DCG）用于小儿川崎病（KD）合并冠状动脉损伤（CAL）的诊断意义。方法回顾性分析70例KD患儿,全部患儿均接受常规心电图（ECG）和DCG检查,以冠状动脉造影检查结果为“金标准”,分析ECG和DCG检查的诊断结果、诊断效能及预测值,并对比两种检查方式的异常检出率。结果本组70例KD患儿中,经冠状动脉造影检查显示合并CAL 48例,未合并CAL 22例;经ECG检查显示合并CAL 33例,未合并CAL 20例;经DCG检查显示合并CAL 47例,未合并CAL 21例。DCG检查灵敏度97.92%（47/48）、准确性97.14%（68/70）较ECG检查68.75%（33/48）、75.71%（53/70）高,且漏诊率2.08%（1/48）较ECG检查31.25%（15/48）低（P<0.05）。DCG检查阴性预测值95.45%（21/22）较ECG检查57.14%（20/35）高（P<0.05）。KD合并CAL患儿中DCG异常检出率97.92%（47/48）较ECG检查68.75%（33/48）高,且KD合并CAL患儿ECG、DCG异常检出率97.92%（33/48）、68.75%（47/48）较KD未合并CAL患儿9.09%（2/22）、4.55%（1/22）高（P<0.05）。结论 DCG用于小儿KD合并CAL的诊断中具有较高灵敏度和准确性,还可降低误诊率,提升阴性预测值,且该检查方式能准确检出患儿异常状况,为临床拟定治疗方案提供参考依据。

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关键词 ：小儿川崎病, 冠状动脉损伤, 动态心电图

Abstract：Objective To investigate the diagnostic significance of dynamic electrocardiography（DCG）for pediatric Kawasaki disease（KD）combined with coronary artery injury（CAL）. Methods We retrospectively analyzed 70 children with KD,all of whom underwent conventional electrocardiography（ECG）and DCG,and analyzed the diagnostic results,diagnostic efficacy,and predictive value of ECG and DCG using coronary arteriography as the“gold standard” and compared the detection rate of abnormalities between the two modalities.The diagnostic results,diagnostic efficacy and predictive value of ECG and DCG were analyzed,and the detection rate of abnormalities of the two examinations was compared. Results Among the 70 children with KD in our group,48 cases of combined CAL and 22 cases of uncomplicated CAL were demonstrated by coronary angiography;33 cases of combined CAL and 20 cases of uncomplicated CAL were demonstrated by ECG;47 cases of combined CAL and 21 cases of uncomplicated CAL were demonstrated by DCG.The sensitivity of DCG examination was 97.92%（47/48）,the accuracy of 97.14%（68/70）was higher than ECG examination 68.75%（33/48）and 75.71%（53/70）,and the leakage rate of 2.08%（1/48）was lower than ECG examination 31.25%（15/48）（P<0.05）.The negative predictive value of DCG examination was higher in 95.45%（21/22）compared with that of ECG examination 57.14%（20/35）（P<0.05）.The detection rate of DCG abnormality was higher in 97.92%（47/48）of children with KD combined with CAL than in 68.75%（33/48）of children with ECG examination,and the detection rate of ECG and DCG abnormality was higher in 97.92%（33/48）and 68.75%（47/48）of children with KD combined with CAL than in 9.09%（2/22）（4.55%）,4.55%（1/22）higher（P<0.05）. Conclusion DCG has high sensitivity and accuracy in the diagnosis of pediatric KD combined with CAL,and it can reduce the misdiagnosis rate and improve the negative predictive value,and it can accurately detect the abnormal conditions of the children,which can provide a reference basis for the clinical development of the treatment plan.

Key words： Pediatric Kawasaki disease Coronary artery injury Ambulatory electrocardiography

收稿日期: 2025-02-08

PACS:

R444

引用本文:

吴好, 王芳, 冯文文. 动态心电图用于小儿川崎病合并冠状动脉损伤的诊断意义[J]. 哈尔滨医药, 2025, 45(1): 31-34.
Wu Hao, Wang Fang, Feng Wenwen. Diagnostic Significance of Ambulatory Electrocardiography for Pediatric Kawasaki Disease Combined with Coronary Artery Injury. journal1, 2025, 45(1): 31-34.

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