心电散点图在窦性心律失常二联律鉴别诊断中的应用  

Application of ECG scatterplot in differential diagnosis of bigeminy of sinus arrhythmia

作　　者：许以德 许智永 

机构地区：[1]福建医科大学附属漳州市医院心电图室,福建漳州363000

出　　处：《实用心电学杂志》2017年第3期175-178,225,共5页Journal of Practical Electrocardiology

摘　　要：目的对窦性早搏二联律、3∶2文氏型窦房阻滞及窦房结功能"纵向"分离导致的长短二联律进行鉴别诊断。方法对在漳州市医院心电图室行24 h动态心电图检查的26例确诊为窦性心律失常二联律的患者,采用Lorenz散点图与时间RR间期(t-RR)散点图及逆向技术相结合的方法进行分析及计算机作图。结果对窦性早搏二联律、3∶2文氏型窦房阻滞及窦房结功能"纵向"分离所致长短二联律的鉴别诊断,不能单纯依靠常规心电图,而应结合Lorenz散点图、t-RR散点图及逆向技术,才能对这三者做出较为准确的鉴别诊断。结论利用心电散点图及逆向技术对窦性心律失常二联律现象进行鉴别诊断,可有效提高诊断符合率并降低漏诊率。Objective To make differential diagnosis of long and short bigeminy resulted from bigeminy of sinus premature beats, 3：2 Wenckebach sinoatrial block and “longitudinal” dissociation of sinus node function. Methods Twenty-six patients diagnosed with bigeming of sinus arrhythmias underwent 24-hour ambulatory electrocardiography examination in the department of electrocardio-gram of Zhangzhou Municipal Hospital. With a combination of Lorenz scatterplot, time-RR-interval scatterplot（t-RR scatterplot） and the reversal technique, the collected clinical data were analyzed and graphs were made by computer. Results To make differential diagnosis of long and short bi-geminy resulted from bigeminy of sinus premature beats, 3：2 Wenckebach sinoatrial block and “longitudinal” dissociation of sinus node function, it is not recommended to simply rely on routine ECG. A combination of Lorenz scatterplot, t-RR scatterplot and the reversal technique helps to make accurate differential diagnosis of these three kinds of bigeminy. Conclusion It can effectively elevate the diagnostic accordance rate and reduce the rate of missed diagnosis to apply ECG scatter-plot and the reversal technique in the differential diagnosis of bigeminy of sinus arrhythmia.

关 键 词：心电图学 心电散点图 窦性早搏 文氏型窦房阻滞 窦性心律失常 二联律 

分 类 号：R541.7[医药卫生—心血管疾病]