目的 探讨心电图(ECG)评分变化对急性肺血栓栓塞症(APTE)患者的诊断价值及临床意义,以期为临床早期诊断、评估病情提供参考,以制定相应干预方案,改善预后。

Objective To investigate the diagnostic value and clinical significance of electrocardiogram (ECG) score changes in patients with acute pulmonary thromboembolism (APTE), with a view to providing reference for early clinical diagnosis and assessment of the condition, in order to develop appropriate intervention plans and improve prognosis.Methods Seventy-nine patients with APTE attending our hospital from October 2019 to October 2021 were selected as the study group, and another 50 patients from the same period of healthy physical examination population were selected as the control group, all of whom underwent ECG examination after admission, comparing ECG scores, serum D-dimer (D-D), ischemic modified serum protein (IMA), and troponin I (TnI) levels between the two groups and patients with different degrees of disease, and comparing the abnormal ECG performance of patients with different degrees of disease, analyzing the correlation between changes in ECG scores and the above serum indicators, and analyzing their diagnostic value for APTE and disease using ROC curves.Results Compared with the control group, ECG score, serum D-D, IMA, and TnI levels were higher in the study group at admission (P < 0.05); compared with the small obstruction group, ECG score, serum D-D, IMA, and TnI levels were higher in the large obstruction group at admission (P < 0.05); tachycardia, incomplete right bundle branch conduction block, V1 lead T-wave inversion, V2-lead T-wave inversion, V3-lead T-wave inversion, III-lead T-wave inversion, and S1Q3T3 were significantly different (P < 0.05). ECG score was positively correlated with serum D-D, IMA, and TnI levels (r=0.812, 0.774, 0.728, P<0.05); the AUC of ECG score, serum D-D, IMA, and TnI for APTE diagnosis was 0.856, 0.832, 0.812, and 0.795, respectively, and the AUC for combined diagnosis was 0.927, and the AUC for APTE disease diagnosis AUC was 0.838, 0.813, 0.783, and 0.769, respectively, and the combined diagnostic AUC was 0.897, all of which were better than the single index diagnosis.Conclusion ECG score is of high value for early diagnosis and disease assessment of APTE, and provides a reference basis for early targeted clinical treatment planning to improve prognosis and reduce the morbidity and mortality rate.