运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值  

Diagnostic value of exercise ECG and dynamic ECG for organic heart disease ventricular premature beat

作　　者：刘冰[1] 

机构地区：[1]陕西省商洛市中心医院心电科,陕西商洛726000

出　　处：《心血管康复医学杂志》2017年第5期542-546,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值。方法:选择我院室性早搏患者135例,根据检查结果分为器质性心脏病组(75例)与非器质性心脏病组(60例)。比较两组运动心电图与动态心电图结果。结果:与非器质性心脏病组比较,器质性心脏病组LownⅠ、Ⅱ级所占比例明显降低,LownⅢ、Ⅳ-A、Ⅳ-B级比例显著升高(P<0.05或<0.01)。动态心电图显示,与非器质性心脏病组比较,器质性心脏病组B型(90.0%比14.67%)所占比例明显降低,A(1.67%比49.33%)、D型(0%比34.67%)所占比例明显升高(P均=0.001);运动心电图显示,与非器质性心脏病组比较,器质性心脏病组E型(61.67%比14.67%)所占比例明显降低,F型(38.33%比85.33%)、缺血型ST段改变(0%比40.0%)所占比例明显升高(P均=0.001)。器质性心脏病组合并房性早搏、阵发性室上性心动过速、心房扑动发生率明显高于非器质性心脏病组(P<0.05或<0.01)。运动心电图和动态心电图诊断器质性心脏病室性早搏的敏感性,特异性,阳性预测值,阴性预测值与准确度均较高,但二者无统计学差异(P均>0.05)。结论:运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值显著,二者无显著差异,值得临床推广。Objective：To explore diagnostic value of exercise ECG and dynamic ECG （DCG）for organic heart disease （OHD）ventricular premature beat （VPB）.Methods：A total of 135 VPB patients were selected from our hospital.Ac-cording to examination outcome,they were divided into OHD group （n=75）and non-OHD group （n=60）.Results of ex-ercise ECG and DCG were compared between two groups.Results：Compared with non-OHD group,there were significant reductions in percentages of Lown grade Ⅰ and Ⅱ,and significant rise in percentages of Lown grade Ⅲ,IV-A and IV-B in OHD group,P 〈0.05 or 〈0.01. DCG indicated that compared with non-OHD group,there was significant reduction in percentage of type B （90.0% vs.14.67%）,and significant rise in percentages of type A （1.67% vs.49.33%）and D （0% vs.34.67%）in OHD group,P =0.001 all;exercise ECG indicated that compared with non-OHD group,there was significant reduction in percentage of type E （61.67% vs.14.67%）,and significant rise in percentages of type F （38.33%vs.85.33%）and ischemic ST segment change （0% vs.40.0%）in OHD group,P =0.001 all.Compared with non-OHD group,there were significant rise in incidence rates of atrial premature beat,paroxysmal supraventricular tachycardia,atrial flutter in OHD group,P 〈0.05 or 〈0.01.Sensitivity,specificity,positive and negative predictive value and accuracy of exercise ECG and DCG were higher both,and there were no significant difference between two groups （P 〉0.05 all）. Conclusion：Diagnostic value of exercise ECG and DCG are significant for organic heart disease ventricular premature beat, but it is no significant difference between two methods,which is worth extending.

关 键 词：心电描记术 便携式 运动试验 室性早搏复合征 

分 类 号：R540.41[医药卫生—心血管疾病]