动态心电图长R-R间期对中老年患者病窦综合征诊断价值的探讨  

Evaluation of long R-R pause in dynamic electrocardiography in the diagnosis of sick sinus syndrome of middle aged and older patients

作　　者：宋波[1] 梅霞[1] 李正恭[1] 

机构地区：[1]重庆市中山医院心内科,400013

出　　处：《重庆医学》2006年第2期149-151,共3页Chongqing medicine

摘　　要：目的统计分析1999年1月-2005年1月期间在我院进行动态心电图（DCG）检查的中老年患者长RR间期检出资料，探讨DCG中的长R—R间期对病态窭房结综合征（SSS）的诊断价值。方法6年内我院年龄50岁以上且经动态心电图检查的患者中，发现1．5s以上长R—R间期且已进行心内电生理检查或食道心房调搏者95例，其中确诊SSS27例；据长R—R间期时限分为1．5～1．9s组、2．0～2．9s组和≥3s组，以探讨长R—R间期对SSS的诊断价值。结果3组患者中SSS比例分别为8．5％、48．0％、90．9％；窦房结恢复时间（SNRT）分别为（1670±180）ms、（2230±350）ms、（3600±860）ms；校正窭房结恢复时间（CS—RT）分别为（330±80）ms、（660±210）ms、（1800±710）ms。长R—R间期值与SNRT值相关系数r=0．965，P〈0．01；长R—R间期值与CSRT值相关系数r-0．976，P〈0．01。结论动态心电图检出的长RR间期时限与SSS有一定相关性，据长R—R间期时限大小，可对SSS诊断有一定提示作用。作为一种无创检查，动态心电图具有较大的实用意义。Objective To disseuss the diagnostic value of long R-R pause in dynamie eleetroeardiography （DCG） in sick sinus syndrome （ SSS ） through the data of the middle aged and older patients examined with DCG in our hospital from Jan. 1999 to Jan. 2005. Methods Of patientsl aged over 50 were examined with DCG in our hospital, 95 patients had the phenomenon of long R-R pause over 1.5s in DCG and were examined by the invasive cardiac electrophysiologic testing or trans-esophogea cardiac pacing at the same time. Finally 27 patients were diagnosed as SSS. Aeording to the long R-R pause , the patients were divided into three groups;1.5-1.9s group, 2.0-2.9s group, ≥3s group in order to investigate the diagnostic value of long R-R pause to SSS. Results Among of the three groups, the proportions of SSS were 8. 5%, 48. 0%, 90. 9% separately; sinus node recovery time （SNRT） was （ 1 670±180） ms, （ 2 230±350） ms, （ 3 600±860） ms separately; Corrected sinus node reeovery time （CRST） was （330±80）ms, （660±210）ms, （1 800±710）ms separately. There was positive correlation between long R-R pause and SNRT（r= 0. 965,P〈50.01）;There was positive correlation between long R-R pause and CSRT（r=0. 976,P〈0.01）. Conclusion The long R-R pause in DCG has some interrelation with SSS, so the long R-R pause clues us to the diagnosis of SSS. DCG has preferable practical values as a kind of non-invasive test.

关 键 词：病窦综合征 动态心电图 长R—R间期 

分 类 号：R541.7[医药卫生—心血管疾病]