动态心电图诊断阵发性室性心动过速的临床价值分析  

Clinical value of holter in diagnosis of paroxysmal ventricular tachycardia

作　　者：于霜 于欣 杨玉柱 Yu Shuang;Yu Xin;Yang Yuzhu(Shan County Central Hospital,Heze,Shandong 274300,China)

机构地区：[1]山东省单县中心医院,山东菏泽274300

出　　处：《首都食品与医药》2023年第1期51-53,共3页Capital Food Medicine

摘　　要：目的探讨动态心电图诊断阵发性室性心动过速(PVT)的临床价值.方法选取单县中心医院2020年5月-2022年6月收治的238例PVT患者为研究对象,患者到院后进行常规心电图、动态心电图的检测,对其心电图特征进行分析,探讨两种心电图检测方式PVT检出率,分析238例患者发生PVT阵次及特点.依据心电图波形特征将患者按照起源室的差异分成两组,其中右室起源室速组(n=125,简称右室组)、左室起源室速组(n=113,简称左室组).对两组患者的心电图特征进行分析比较,包括QRS电轴、QRS时限、QT离散度、平均心室率.结果动态心电图在238例PVT患者中进行诊断,检出率为97.06%(231/238),常规心电图在238例PVT患者中进行诊断,检出率为71.01%(169/238),动态心电图PVT患者的检出率显著高于常规心电图(P<0.05).动态心电图其PVT阵次检出情况显示,1阵次检出39例,2-10阵次检出86例,10阵次以上检出106例;常规心电图其PVT阵次检出情况显示,1阵次检出4例,2-10阵次检出65例,10阵次以上检出100例.两种检测方式在1阵次、2-10阵次的检出率存在显著差异(P<0.05).动态心电图检测PVT合并多形性室性心动过速、单形性室性心动过速,其检出率高于常规心电图(P<0.05).按照起源心室分组,右室组QRS电轴显著低于左室组(P<0.05);两组QRS时限、QT离散度、平均心室率对比差异不显著(P>0.05).结论动态心电图在PVT的诊断中具有较高的检出率,尤其是对非持续性PVT患者的检出率较高,能够发现PVT阵次较少的患者,使其及早得到干预治疗.同时动态心电图可分析患者QRS电轴、QRS时限、QT离散度特点,为医师明确疾病原因,制定合理的诊疗方案提供更多的参考信息.Objective To investigate the clinical value of holter in the diagnosis of paroxysmal ventricular tachycardia(PVT).Methods A total of 238 patients with PVT admitted to our hospital from May 2020 to June 2022 were selected as the research objects.Routine electrocardiogram(ECG)and holter electrocardiogram(HOLTER)were performed after admission to the hospital.The ECG characteristics of the patients were analyzed,the detection rate of PVT by two ECG detection methods was discussed,and the PVT array and characteristics of 238 patients were analyzed.According to the ECG waveform characteristics,the patients were divided into two groups according to the difference of origin ventricle,including right ventricular tachycardia group(n=125,referred to as right ventricular group)and left ventricular tachycardia group(n=113,referred to as left ventricular group).The ECG characteristics of the two groups were compared and analyzed,including QRS axis,QRS duration,QT dispersion and mean ventricular rate.Results The detection rate of dynamic electrocardiogram was 97.06%(231/238)in 238 PVT patients,and the detection rate of conventional electrocardiogram was 71.01%(169/238).The detection rate of dynamic electrocardiogram in PVT patients was significantly higher than that of conventional electrocardiogram(P<0.05).The detection of PVT sequence in holter showed that 39 cases were detected at 1 sequence,86 cases were detected at 2-10 sequence,and 106 cases were detected at more than 10 sequence.The detection of PVT sequences in routine ECG showed that 4 cases were detected at 1 sequence,65 cases were detected at 2-10 sequence,and 100 cases were detected at more than 10 sequences.There were significant diferences in the detection rates of the two detection methods at 1 array and 2-10 arrays(P<0.05).The detection rate of PVT complicated with pleomorphic ventricular tachycardia and monomorphic ventricular tachycardia by holter was higher than that by conventional ECG(P<0.05).The QRS axis of the right ventricular group was significantly low

关 键 词：动态心电图 阵发性心动过速 心脏疾病 心肌损伤 心电图波形 

分 类 号：R541.71[医药卫生—心血管疾病]