探讨应用动态心电图诊断心律失常性晕厥的价值  

Value of Dynamic Electrocardiogram in the Diagnosis of Arrhythmic Syncope

作　　者：吕昌盛 梁鹏 王元元 LYU Changsheng;LIANG Peng;WANG Yuanyuan(Special Examination Department,Jinan Eighth People's Hospital,Ji'nan,Shandong Province,271104 China;Department of Rehabilitation Medicine,Jinan Eighth People's Hospital,Ji'nan,Shandong Province,271104 China)

机构地区：[1]济南市第八人民医院特检科,山东济南271104 [2]济南市第八人民医院康复医学科,山东济南271104

出　　处：《世界复合医学》2023年第6期16-19,共4页World Journal of Complex Medicine

基　　金：济南市卫生健康委员会2022年委科技计划项目,济卫科教发[2022]2号(2022-2-87)。

摘　　要：目的 探讨应用动态心电图诊断心律失常性晕厥的价值。方法 选取2020年10月—2022年12月济南市第八人民医院特检科接受收的90例疑似存在心源性晕厥患者为研究对象。分别均实施静息心电图描记和动态心电图动态进行检测。以临床综合诊断为金标准,比较两种检查方法对心律失常性晕厥的检出率,准确率、灵敏度、特异度,研究两种检查方法对快速型心律失常、缓慢型心律失常、特殊心电图波型心律失常的诊断符合率以及对预警猝死标志心电波形的诊断符合率。结果 90例疑似患者最终诊断75例心律失常性晕厥(83.33%),动态心电图诊断准确率81.11%、灵敏度80.00%、特异度86.67%,均高于常规心电图的37.78%、40.00%、26.67%,差异有统计学意义(χ^(2)=5.667、5.000、4.923,P=0.017、0.025、0.027)。动态心电图对快速型心律失常、缓慢型心律失常、特殊心电图波型心律失常诊断符合率高于常规心电图,差异有统计学意义(P<0.05)。动态心电图对J波综合征、长QT综合征、早复极综合征、Ⅰ型Brugada波、Lambda波诊断符合率高于常规心电图,差异有统计学意义(P<0.05)。结论 在心律失常性晕厥的诊断中,采用动态心电图诊断效果显著,临床价值较高,对心律失常性猝死早期心电图诊断具有积极意义。Objective To investigate the value of dynamic electrocardiogram in the diagnosis of arrhythmic syncope.Methods A total of 90 patients with suspected cardiogenic syncope admitted to the special Clinic of Jinan Eighth People's Hospital from October 2020 to December 2022 were selected as the study objects.Static electrocardiography and dynamic electrocardiography were performed respectively.With clinical comprehensive diagnosis as the gold standard,the detection rate,accuracy,sensitivity and specificity of the two examination methods for arrhythmia syncope were compared,and the diagnosis coincidence rate of tachyarrhythmia,bradyarrhythmia and special electrocardiogram wave arrhythmia and the diagnosis coincidence rate of ECG waveform of warning sudden death sign were studied.Results Of the 90 suspected patients,75 cases were diagnosed with arrhythmia syncope(83.33%).The diagnostic accuracy of holter ECG was 81.11%,sensitivity 80.00%and specificity 86.67%,which were higher than that of conventional ECG(37.78%,40.00%and 26.67%),the difference was statistically significant(χ^(2)=5.667,5.000,4.923,P=0.017,0.025,0.027).The diagnostic coincidence rate of holter ECG for tachyarrhythmia,tachyarrhythmia and special wave arrhythmia was higher than that of conventional ECG,and the difference was statistically significant(P<0.05).The diagnostic coincidence rate of holter ECG for J wave syndrome,long QT syndrome,early repolarization syndrome,typeⅠBrugada wave and Lambda wave was higher than that of conventional ECG,and the difference was statistically significant(P<0.05).Conclusion In the diagnosis of arrhythmia syncope,the use of holter electrocardiogram has significant effect and high clinical value,and has positive significance for the early diagnosis of sudden arrhythmia death.

关 键 词：心律失常性晕厥 动态心电图 静息心电图 预警猝死波形 

分 类 号：R540.41[医药卫生—心血管疾病]