目的 探讨多模态深度学习融合心脏超声与心电图特征对冠心病患者心源性猝死的预测价值。方法 选取2024年1月—2025年6月收治的60例冠心病患者，所有患者均接受心脏超声、心电图检查及多模态深度学习模型预测，随访6个月记录心源性猝死事件。根据随访结果分为事件组（n=15）和非事件组（n=45），比较两组临床资料及各项指标差异。结果 多模态深度学习模型预测敏感度为86.67%，特异度为91.11%，准确率为90.00%，AUC为0.923，显著优于单独心脏超声（AUC=0.761）和单独心电图（AUC=0.788）。结论 多模态深度学习融合心脏超声与心电图特征能够有效预测冠心病患者心源性猝死风险，预测性能优于传统单一模态评估方法。

      Objective To investigate the predictive value of multimodal deep learning integrating echocardiography and electrocardiogram features for sudden cardiac death in patients with coronary heart disease．Methods A total of 60 patients with coronary heart disease admitted from January 2024 to June 2025 were enrolled．All patients underwent echocardiography，electrocardiogram examination，and multimodal deep learning model prediction，with a 6-month follow-up to record sudden cardiac death events．According to the follow-up results，patients were divided into the event group（n=15） and non-event group（n=45），and clinical data and various indicators were compared between the two groups．Results The multimodal deep learning model achieved a sensitivity of 86.67%，specificity of 91.11%，accuracy of 90.00%，and AUC of 0.923，which were significantly superior to echocardiography alone（AUC=0.761） and electrocardiogram alone（AUC=0.788）．Conclusions Multimodal deep learning integrating echocardiography and electrocardiogram features can effectively predict the risk of sudden cardiac death in patients with coronary heart disease，with predictive performance superior to traditional single-modality assessment methods．

目的 探讨与分析回旋支急性闭塞的心电图表现及相关临床表现和病变血管特点。方法 选择2018年1月—2023年6月在鹤壁市人民医院诊治的回旋支闭塞引起急性心肌梗死46例,检测与调查患者的心电图表现、相关临床表现、病变血管特点,随访患者的预后情况。结果 在46例患者中,冠状动脉造影检查判断为近中段闭塞23例（近中段组）,远段闭塞23例（远段组）。近中段组与远段组一般资料比较差异无统计学意义（P>0.05）。近中段组的心电图特征中的ST V1~ V3压低、ST Ⅱ、Ⅲ、aVF抬高、ST Ⅱ、Ⅲ、aVF压低、TV2>TV5、ST Ⅰ~aVL压低、ST Ⅰ~aVL 抬高、ST V7~V9抬高等占比分别为60.87%、47.83%、8.70%、43.48%、69.57%、17.39%、60.87%,远段组的占比分别为4.35%、82.61%、0%、17.39%、30.43%、8.70%、60.87%;近中段组与远段组心电图表现有相似处及各自特征。所有患者随访至2023年8月1日,近中段组与远段组的平均随访时间为（32.69±4.20）个月与（32.92±3.28）个月,近中段组与远段组心血管不良事件发生率比较差异无统计学意义（P>0.05）。受试者操作特征（ROC）曲线分析显示心电图对近中段回旋支急性闭塞患者的预测曲线下面积为0.793（95%CI：0.678~0.914,P=0.000）,灵敏度为78.22%,特异度为81.91%。结论 心电图在急性梗死患者的应用能辅助判定梗死相关动脉回旋支状况,可辅助判断患者的梗死部位,对患者的预后评估也具有重要价值。

Objective To explore and analysis the electrocardiogram manifestations,related clinical manifestations and pathological vascular characteristics of acute occlusion of the circumflex branch. Methods A total of 46 cases of acute myocardial infarction caused by circumflex branch occlusion diagnosed and treated in Hebi People's Hospital from January 2018 to June 2023 were selected as the study subjects,and the electrocardiographic manifestations,related clinical manifestations and characteristics of diseased blood vessels of the patients were detected and investigated,and the prognosis of the patients was followed up. Results Among the 46 patients,23 cases were diagnosed with proximal mid-segment occlusion（proximal mid-segment group）and 23 cases were diagnosed with distal segment occlusion（distal segment group）by coronary angiography．There was no significant difference in the comparison of the general data of the two groups（P>0.05）．The ECG features of ST V1- V3 depression,ST Ⅱ,Ⅲ,aVF elevation,ST Ⅱ,Ⅲ,aVF depression,TV2>TV5,ST I-aVL depression,ST I-aVL elevation and ST V7-V9 elevation in the proximal mid-segment group were 60.87%,47.83%,8.70%,43.48%,and 69.57%,17.39%,60.87%,and 4.35%,82.61%,0%,17.39%,30.43%,8.70%,60.87% in the distal segment group;there were similarities in the electrocardiographic manifestations of the proximal mid-segment group and the distal segment group as well as their respective characteristics．All patients were followed up until August 1,2023,and the mean follow-up time of the proximal mid- and distal segment groups was 32.69±4.20 months versus 32.92±3.28 months,and the incidence of adverse cardiovascular events was 26.09% in the proximal mid-group．There was no difference in the incidence of cardiovascular adverse events between the two groups（P>0.05）．ROC curve analysis showed that the area under the prediction curve of electrocardiogram for patients with acute occlusion of the proximal circumflex artery were 0.793（95% CI：0.678-0.914,P<0.001）,sensitivity was 78.22% and specificity was 81.91%．Conclusions Electrocardiogram has important predictive value in diagnosing acute myocardial infarction in which the infarct related artery is a circumflex branch．It can auxiliary determine the infarct site of patients and also auxiliary evaluate the prognosis of acute myocardial infarction patients．

目的 通过比较二胎孕妇和初产孕妇心电图变化探讨其对妊娠结局的影响。方法 随机选取300例孕妇,其中150例二胎孕妇为观察组,150例初产孕妇为对照组。观察2组孕妇异常心电图的类型及发生率,分析异常心电图与妊娠结局的关系。结果 初产孕妇组异常心电图35例,心电图异常发生率为23.3%,二胎孕妇组异常心电图50例,心电图异常发生率为33.3%,两组心电图异常发生率差别有统计学意义(P<0.05)。二胎孕妇组窦性心动过速、室性早搏及ST-T改变的发生率显著高于初产孕妇组,差异有统计学意义(P<0.05)。二胎孕妇心电图异常组的剖宫产率和早产率均高于二胎孕妇心电图正常组、初产孕妇心电图正常组,差别有统计学意义(P>0.05)。结论 二胎孕妇易合并心电图异常改变,心电图异常会增加剖宫产和早产的发生率,临床医生在诊治此类患者时应提高警惕。

Objective To observe the relationship between electrocardiogram(ECG) and pregnancy outcomes of the second pregnant women. Methods Pregnant women were divided into two groups by parity history: the second pregnancy group and the Primipara group. The incidence of abnormal electrocardiogram was recorded, then the pregnancy outcome including the delivery mode and the premature birth rate were followed up. Results The incidence of abnormal ECG in the second pregnancy group was significantly higher than that in primipara group(P<0.05) and the incidences of Nodal tachycardia, Premature ventricular contraction, ST-T changes in the group of the second pregnancy were higher than that in the group of Primipara (P<0.05). The incidence of cesarean delivery and premature birth in the second pregnancy group with abnormal ECG group was significantly higher than that in pregnant women with normal ECG group (P<0.05). Conclusion The second pregnant women are more likely to have ECG abnormality, the pregnant women with abnormal ECG are easily suffer from cesarean delivery and premature birth.