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目的探索一个新的非线性检测指标在冠心病诊断中的价值。方法选取2008年3月至2009年2月哈尔滨医科大学附属第一医院住院患者,对临床表现拟诊冠心病患者在行冠状动脉造影的前一夜固定时间进行心电数据采集,剔除分析的心搏数RR间期小于90%者,最终选取124例患者为研究对象,根据冠状动脉造影结果分为冠心病组53例,中间组38例和正常组33例,3组患者均给予常规检查。所获得的RR间期数据由试验者仔细检查后盲性移交给专业人员,进行数据过滤、由50步混沌强度公式分析计算后输出。运用诊断试验方法并绘制ROC曲线进行分析。结果 3组间总体比较50步混沌强度(50SCM)差异有统计学意义(P<0.01),与对照组比较,冠心病患者的50SCM明显降低(P<0.01)。ROC曲线显示的50SCM最佳截断点是3.126,此时的敏感度为91%、特异度为82%、准确度为87%、阳性似然比5.06、阴性似然比0.1。结论冠心病患者的50SCM明显降低;50SCM为3.126时有助于诊断冠心病。
Objective To explore the value of a new non-linear test in the diagnosis of coronary heart disease. Methods From March 2008 to February 2009, Harbin First Affiliated Hospital of Harbin Medical University inpatients, clinical manifestations of patients with coronary heart disease coronary artery angiography in the night before fixed-time ECG data acquisition, analysis and removal of heart rate Number of RR interval less than 90%, the final selection of 124 patients for the study, according to coronary angiography results were divided into coronary heart disease group of 53 cases, 38 cases of intermediate group and 33 cases of normal group, 3 patients were given routine examination. The obtained RR interval data is blindly handed over to the professionals by the experimenter for data filtration, and the output is analyzed and calculated by 50 steps of the chaos intensity formula. Use diagnostic test methods and draw ROC curves for analysis. Results The overall 50-step chaotic intensity (50SCM) was significantly different among the three groups (P <0.01). Compared with the control group, the 50SCM of patients with coronary heart disease was significantly lower (P <0.01). The best cut-off point of 50 SCM showed by ROC curve was 3.126, the sensitivity was 91%, the specificity was 82%, the accuracy was 87%, the positive likelihood ratio was 5.06 and the negative likelihood ratio was 0.1. Conclusion 50SCM in patients with coronary heart disease was significantly lower; 50SCM was 3.126 when diagnosed with coronary heart disease.