改良心脏固有心率测定诊断窦房结功能障碍  

Application value of modified intrinsic heart rate in the diagnosis of sinoatrial node dysfunction

作　　者：黄静瑜 黄启祥[1] 罗桥根 方红[1] Huang jingyu;Huang qixiang;Luo qiaogen;Fang hong(Department of electrophysiology,Jiangmen Centred Hospital,Guangdong,Jiangmen,529000,China)

机构地区：[1]广东省江门市中心医院,529000

出　　处：《临床心电学杂志》2022年第2期98-101,共4页Journal of Clinical Electrocardiology

摘　　要：目的 探讨改良固有心率测定在窦房结功能障碍诊断中的作用。方法 收集我院2018年1月至2019年5月的心电生理室30例住院患者资料,根据病史、症状、动态心电图检查及临床诊断结果分为单纯窦性心动过缓(A组)和病态窦房结综合征组(B组)。使用改良心脏固有心率测定方法测定两组患者的心脏固有心率,分别记录阿托品和艾司洛尔使用后各时点的心率水平,用ROC曲线对比改良试验和阿托品试验结果,并用相关性分析探讨预测值与测量值之间的相关性。在对两组患者进行随访过程中再次用改良测定试验进行对比评估。结果 A组患者用改良方法测定的固有心率值为85.75±8.90次/分,B组为72.50±6.38次/分,两组差异有统计学意义(p<0.001),注射艾司洛尔后的心率记录结果显示两组在各时点下均有显著性差异。ROC曲线结果显示,改良试验的曲线下面积(AUC)为0.887(95%可信区间:0.770-1.000),比阿托品高[AUC:0.788(95%可信区间:0.606-0.969)]。改良试验测量值与预测值之间的对比显示两者不相关(p=0.814)。用改良试验对随访数据进行对比评估,1年后患者测量值没有显著变化。结论 改良心脏固有心率测定对窦房结功能障碍有鉴别诊断作用,其特异性及敏感性优于阿托品试验,有助于筛查出窦房结功能障碍的患者,从而指导临床治疗。Objective To investigate the role of improved intrinsic heart rate in the diagnosis of sinoatrial node dysfunction. Methods Thirty patients were studied in our research, whose data were collected in the department of electrophysiology from January 2018 to May 2019. According to the medical history, symptoms, ambulatory ECG and clinical diagnosis results, they were divided into simple sinus bradycardia(group A) and sick sinus syndrome group(group B). The intrinsic heart rate of the two groups was measured by the improved intrinsic heart rate measurement method, and the heart rate levels at each time point after Atropine and Esmolol were recorded respectively. The results of the improved test and atropine test were also compared by ROC curve with the Astropine test, and the correlation between the predicted value and the measured value was discussed by correlation analysis. During the follow-up of the two groups of patients, the modified test was used for comparative evaluation again. Results The intrinsic heart rate measured by the improved method was 85.75 ± 8.90bpm in group A and 72.50 ± 6.38bpm in group B. There was significant difference between the two groups(p<0.001). The heart rate recording results after Esmolol injection showed that there were significant differences between the two groups at each time point. The ROC curve showed that the area under the curve of modified test was 0.887(95% CI: 0.770-1.000), which was higher than atropine test(0.788, 95%CI:0.606-0.969). The comparison between the measured and predicted values of the improvement test showed that they were not correlated(p=0.814). It was found that no significant change in the patient’s measurement after 1 year when comparing and evaluating follow-up data by the modified test. Conclusions The improved intrinsic heart rate measurement has a differential diagnostic role in the diagnosis of sinoatrial node dysfunction. Its specificity and sensitivity are better than atropine test, and it can help to screen patients with sinoatrial node dysf

关 键 词：窦房结功能障碍 心脏固有心率 阿托品 艾司洛尔 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]