动态心电图与常规心电图诊断无症状性心肌缺血伴发心律失常的临床效果对比研究  

Comparative effectiveness research of DCG and RECG in diagnosing SMI with arrhythmia

作　　者：高国亮 严国平 史亮亮 郭雪芬 GAO Guo-liang;YAN Guo-ping;SHI Liang-liang(Electrocardiogram Room,Xuancheng People’s Hospital of Anhui,Xuancheng 242000,China.)

机构地区：[1]宣城市人民医院心电图室,安徽宣城242000

出　　处：《中国医学装备》2023年第2期68-71,共4页China Medical Equipment

摘　　要：目的:比较动态心电图(Holter)与常规心电图(RECG)诊断无症状性心肌缺血(SMI)伴发心律失常的临床价值。方法:选择医院收治的240例SMI患者,经RECG检查后Holter连续监测24 h。比较两种检查方法的SMI检出率、SMI发作时心电图表现中的心率、ST段下移距离、心肌缺血持续时间以及心律失常检出率。结果:Holter和RECG对SMI的检出率分别为70.83%(170/240)和40.00%(96/240),两种方法比较差异有统计学意义(χ^(2)=15.726,P<0.05)。Holter检查的心率和心肌缺血持续时间均明显高于RECG检查,ST段下移距离明显低于RECG检查,差异均有统计学意义(t=19.284,t=7.532,t=16.738;P<0.05)。Holter对早发期室性心律失常、早发期房性心律失常的检出率均明显高于RECG,差异均有统计学意义(χ^(2)=8.947,χ^(2)=6.795;P<0.05)。结论:Holter能有效提高SMI伴发心律失常的检出率,能获得更加全面的心电参数,临床价值更高。Objective: To compare the clinical value of dynamic electrocardiogram(DCG) Holter and routine electrocardiogram(RECG) in diagnosing silent myocardial ischemia(SMI) with arrhythmia. Methods: A total of 240 patients with SMI admitted to Hospital were selected. All of them underwent continuous monitoring within 24h by DCG Holter. And then, the SMI detection rate, the heart rate, the descent distance of ST segment, the duration of myocardial ischemia and the detection rate of arrhythmia when occurred SMI between the two methods were compared. Results:The detection rates of DCG Holter and RECG were 70.83%(170/240) and 40.00%(96/240) on SMI, respectively, and the difference of that between the two methods was statistically significant(x~2=15.726, P<0.05). The heart rate and the duration of myocardial ischemia in Holter examination were significantly higher than those in RECG examination, and the descent distance of ST segment was significantly lower than that in RECG examination, and the differences of them between two methods were statistically significant(t=19.284, t=7.532, t=16.738, P<0.05), respectively. The detection rates of Holter for premature ventricular arrhythmia and premature atrial arrhythmia were significantly higher than those of RECG(x~2=8.947, x~2=6.795, P<0.05). Conclusion: Holter can effectively improve the detection rate of SMI with arrhythmia and obtain more comprehensive electrocardiogram parameters, which clinical value is higher.

关 键 词：无症状性心肌缺血(SMI) 心律失常 12导联 动态心电图(Holter)监测 常规心电图(RECG) 

分 类 号：R542.2[医药卫生—心血管疾病]