24h动态心电图在房性快速心律失常患者中的诊断价值  

Diagnostic Value of 24-h Dynamic Electrocardiogram in Patients with Atrial Tachyarrhythmias

作　　者：罗洋 徐荣华[1] 陆应雄 艾可明 乔娟[1] 赵怒 LUO Yang;XU Ronghua;LU Yingxiong;AI Keming;QIAO Juan;ZHAO Nu(Department of Electrocardiography,Kunming First People's Hospital,Kunming,Yunnan Province,650000 China)

机构地区：[1]云南省昆明市第一人民医院心电图室,云南昆明650000

出　　处：《世界复合医学》2023年第1期115-119,共5页World Journal of Complex Medicine

摘　　要：目的 探究24 h动态心电图在房性快速心律失常患者中的诊断价值。方法 2020年6月—2021年4月回顾性分析昆明市第一人民医院收治的139例患者的临床资料。按照发生频率和类型,将所有患者分为偶发房早组(46例)、频发房早及短阵房速组(46例)、阵发性房颤组(47例),另再选取同期健康体检者45名为健康对照组。所有研究对象均进行24 h动态心电图检查。比较Pd、Pmax、LADD水平,Pd、Pmax、Pd+Pmax阳性率,Pd、Pmax、Pa+Pmax对房性快速心律失常的预测值。结果 阵发性房颤组Pd、Pmax水平为[(44.67±12.04)、(110.93±15.70)ms]、频发房早及短阵房速组[(41.99±13.85)、(107.65±13.88)ms]、偶发房早组[(35.98±14.05)、(101.96±11.79)ms]均高于健康对照组[(28.51±12.48)、(84.36±11.09)ms];且频发房早及短阵房速组、阵发性房颤组均高于偶发房早组差异有统计学意义(P<0.05);阵发性房颤组LADD水平(41.02±11.75)mm高于健康对照组(35.50±10.43)mm、偶发房早组(35.78±11.87)mm,差异有统计学意义(P<0.05)。频发房早及短阵房速组、阵发性房颤组中Pd、Pmax、Pd+Pmax阳性率高于偶发房早组,差异有统计学意义(P<0.05)。Pd+Pmax的阳性预测值、灵敏度、阴性预测值、特异度高于Pd、Pmax,且Pmax高于Pd,差异有统计学意义(P<0.05)。结论 P波离散度是可以作为预测房性心律失常的一个新的指标,同时Pd联合Pmax检查具有更高的预测值,故诊断价值更高。Objective To investigate the diagnostic value of 24-h dynamic electrocardiogram in patients with atrial tachyarrhythmias.Methods From June 2020 to April 2021,the clinical data of 139 patients admitted to Kunming First People's Hospital were analyzed retrospectively.According to the frequency and type of occurrence,all patients were divided into episodic atrial premature group(46 patients),frequent atrial premature and short paroxysmal atrial tachycardia group(46 patients),and paroxysmal atrial fibrillation group(47 patients),and another 45 patients were selected as healthy controls during the same period of healthy control group.All study subjects underwent 24-h dynamic electrocardiogram examination.The predictive values of Pd,Pmax,LADD levels,positive Pd,Pmax,Pd+Pmax,and Pd,Pmax,and Pa+Pmax for atrial tachyarrhythmias were compared.Results The levels of Pd and Pmax in paroxysmal atrial fibrillation group[(44.67±12.04)ms,(110.93±15.70)ms],frequent atrial premature and short atrial tachycardia group[(41.99±13.85)ms,(107.65±13.88)ms],episodic atrial premature group[(35.98±14.05)ms,(101.96±11.79)ms]were higher than those in healthy control group[(28.51±12.48)ms,(84.36±11.09)ms],the difference was statistically significant(P<0.05)and the levels of frequent atrial premature and short paroxysmal atrial tachycardia group and paroxysmal atrial fibrillation group were higher than those in episodic atrial premature group,The level of LADD in paroxysmal atrial fibrillation group(41.02±11.75)mm was higher than that in healthy control group(35.50±10.43)mm and sporadic atrial premature group(35.78±11.87)mm,the difference was statistically significant(P<0.05).The positive rates of Pd,Pmax and Pd+Pmax in frequent atrial premature and short paroxysmal atrial tachycardia group and paroxysmal atrial fibrillation groups were higher than those in episodic atrial premature group,the difference was statistically significant(P<0.05).The positive predictive value,sensitivity,negative predictive value and specificity of Pd+Pmax

关 键 词：房性 快速心律失常 24H动态心电图 诊断价值 

分 类 号：R4[医药卫生—临床医学]