12导联动态心电图、常规心电图在无症状冠心病心肌缺血伴发心律失常诊断中的价值  

The Value of 12-lead Holter Electrocardiogram and Routine Electrocardiogram in the Diagnosis of Myocardial Ischemia with Arrhythmia in Asymptomatic Coronary Heart Disease

作　　者：贾慧芳[1] JIA Hui-fang(Electrocardiogram Room,Tianjin First Hospital,Tianjin 300000,China)

机构地区：[1]天津市第一医院心电图室,天津300000

出　　处：《医学信息》2023年第11期126-129,共4页Journal of Medical Information

摘　　要：目的探究12导联动态和常规心电图在无症状冠心病心肌缺血伴发心律失常诊断中的价值。方法选取2021年6月-2022年6月在我院诊治的95例冠心病患者为研究对象,均进行12导联动态心电图、常规心电图检查,比较两种诊断方式无症状心肌缺血检出率、不同心律失常(室性心律失常、房性心律失常、短阵室上性心动过速、房室传导阻滞)检出率、12导联动态心电图检测有无症状心肌缺血发作时间分布情况。结果12导联动态心电图心肌缺血检出率为81.05%,高于常规心电图检出率的58.94%(P<0.05);12导联动态心电图室性心律失常,房性心律失常的期前收缩二、三联律和成对期前收缩,短阵室上性心动过速,房室传导阻滞检出率均高于常规心电图(P<0.05),室性心律失常、房性心律失常的频发期前收缩检出率比较,差异无统计学意义(P>0.05);12导联动态心电图检查无症状心肌缺血ST改变发作频率大于有症状心肌缺血患者(P<0.05),且有症状、无症状心肌缺血ST改变发作频率最高时间均为06∶00~12∶00、12∶00~18∶00。结论12导联动态心电图可提高无症状冠心病心肌缺血伴发心律失常诊断效能,可提高心肌缺血、心律失常检出率,并且对有症状和无症状心肌缺血加以鉴别,明确冠心病心肌缺血高发时间段,为临床有效治疗和预防心肌缺血发生提供可靠的参考依据。Objective To explore the value of 12-lead Holter electrocardiogram and routine electrocardiogram in the diagnosis of myocardial ischemia with arrhythmia in asymptomatic coronary heart disease.Methods A total of 95 patients with coronary heart disease who were diagnosed and treated in our hospital from June 2021 to June 2022 were selected as the research objects.All patients underwent 12-lead Holter electrocardiogram and routine electrocardiogram.The detection rate of asymptomatic myocardial ischemia,different arrhythmia(ventricular arrhythmia,atrial arrhythmia,short-term supraventricular tachycardia,atrioventricular block)detection rate,12-lead Holter electrocardiogram detection of asymptomatic myocardial ischemia time distribution were compared.Results The detection rate of myocardial ischemia in 12-lead Holter electrocardiogram was 81.05%,which was higher than 58.94%in routione electrocardiogram(P<0.05).The detection rates of premature contraction bi-triple rhythm and paired premature contraction,paroxysmal supraventricular tachycardia and atrioventricular block in 12-lead dynamic electrocardiogram were higher than those in routine electrocardiogram(P<0.05).There was no significant difference in the detection rate of frequent premature contraction between ventricular arrhythmia and atrial arrhythmia(P>0.05).The frequency of ST changes in asymptomatic myocardial ischemia was higher than that in patients with symptomatic myocardial ischemia(P<0.05),and the highest frequency of ST changes in symptomatic and asymptomatic myocardial ischemia was 06∶00-12∶00 and 12∶00-18∶00.Conclusion 12-lead Holter electrocardiogram can improve the diagnostic efficacy of asymptomatic coronary heart disease myocardial ischemia with arrhythmia,improve the detection rate of myocardial ischemia and arrhythmia,and identify symptomatic and asymptomatic myocardial ischemia,and clarify the high incidence of myocardial ischemia in coronary heart disease.It can provide reliable reference for effective clinical treatment and prevention

关 键 词：12导联动态心电图 冠心病 心肌缺血 心律失常 

分 类 号：R541.4[医药卫生—心血管疾病] R541.7[医药卫生—内科学] R542.2[医药卫生—临床医学]