“曲尺”状Lorenz散点图法在心房颤动逸搏心律诊断中的应用  

Application of square shape Lorenz plots in the diagnosis of atrial fibrillation with escape rhythm

作　　者：顾良其 黄忆 GU Liangqi;HUANG Yi(Department of Electrocardiagram,Jiaxing Second Hopital,Jiaxing 314000,China)

机构地区：[1]嘉兴市第二医院心电图室,314000

出　　处：《心电与循环》2020年第6期591-594,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨“曲尺”状Lorenz散点图(简称散点图)法在心房颤动逸搏心律诊断中的意义。方法270例心房颤动患者行动态心电图监测,测定平均心率、最快心率、最慢心率、≥1.5 s RR间期次数、≥2.0 s RR间期次数。根据RR间期分为无逸搏的A组(无长RR间期)和伴有逸搏的B组(有长RR间期),比较两组出现“曲尺”状散点图和扇形散点图的比例。结果A组36例,无“曲尺”状散点图31例,具有“曲尺”状散点图5例(13.89%)。该5例“曲尺”状散点图者根据既往标准诊断不伴逸搏及逸搏心律,但通过逆向分析证实,该5例患者均伴有交接区逸搏及逸搏心律。B组234例,其中只有47例(20.09%)呈现“曲尺”状散点图,187例未出现“曲尺”状散点图改变。47例长RR间期为交接区逸搏及逸搏心律46例,室性逸搏1例。结论“曲尺”状散点图对诊断心房颤动伴逸搏心律较基于RR间期诊断标准更具优势。Objective To evaluate the value of square shape Lorenz plots in the diagnosis of escape rhythm during atrial fibrillation (AF). Methods 270 AF patients underwent ambulatory electrocardiograms examination. Mean heart rate, maximum heart rate, minimum heart rate, the number of RR interval≥1.5 s and ≥2.0 s were recorded. They were divided into group A without escape rhythm (without long RR interval) and group B with escape rhythm (with long RR interval) based on RR interval analysis. The percentage of square shape Lorenz plots and fan shape Lorenz plots was compared between the two groups. Results Of 36 cases in group A, five cases (13.89%) exhibited L-shape Lorenz plots and 31 cased exhibited fan shape Lorenz plots. In the 5 cases with L-shape Lorenz plots, the escape rhythm or beats, which could not be identified based on RR interval analysis, was determined by reverse analysis technique. Of 234 cases in group B, only 47 cases (20.09%) exhibited L-shape Lorenz plots and 187 cases exhibited fan shape Lorenz plots. Of the 47 cases with long RR interval, 46 cases had junctional escape beats or escape rhythm and one had ventricular escape rhythm. Conclusion L-shape Lorenz plots is superior to RR interval-based diagnostic criteria in diagnosing escape rhythm in AF patients.

关 键 词：心房颤动 逸搏心律 LORENZ散点图 RR间期 诊断 

分 类 号：R541.75[医药卫生—心血管疾病]