24 h动态心电图在病态窦房结综合征中的诊断应用价值  

Application value of 24 h holter electrocardiogram in diagnosis of sick sinus syndrome

作　　者：詹雯 袁义燕 焦敬美 孟祥光[1] ZHAN Wen;YUAN Yi-yan;JIAO Jing-mei;MENG Xiang-guang(Department of Electrocardiogram,the 7th Peoples Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院心电图室,郑州450000

出　　处：《医药论坛杂志》2025年第2期185-188,193,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191111)。

摘　　要：目的 探讨病态窦房结综合征(sick sinus syndrome,SSS)临床诊断及类型评估中24 h动态心电图的应用价值。方法 选取2022年10月—2023年11月郑州市第七人民医院收治的SSS患者94例作为观察组,同期接受体检的健康人员96例为对照组。两组均开展24 h动态心电图检查,对两组24 h动态心电图心率情况(24 h总心搏量、24 h平均心率、最低心率、最高心率)、不同类型SSS(I、Ⅱ、Ⅲ、Ⅳ型)发生率、心率<30次/min、<40次/min、<50次/min最长持续时间情况予以比较。结果 观察组24 h总心搏量、24 h平均心率、最低心率及最高心率分别是(75 556.42±13.46)次、(45.61±8.34)次/min、(31.53±4.72)次/min和(89.34±24.80)次/min,均低于对照组,差异有统计学意义(P<0.05);观察组I、Ⅱ、Ⅲ、Ⅳ型SSS的发生率分别为I型11例(11.70%)、Ⅱ型10例(10.63%)、Ⅲ型13例(13.82%)、Ⅳ型11例(11.70%);观察组房性、室性逸搏心律、室速、房速、慢-快综合征、交界性逸搏心律、心室停搏、窦房阻滞、窦性停搏(>2.0 s)及显著窦缓等心律失常检出率均高于对照组,差异有统计学意义(P<0.05);观察组心率<30次/min、<40次/min、<50次/min最长持续时间分别是(8.12±1.21)s、(341.88±51.28)s和(8 876.47±1 331.47)s,均高于对照组,差异有统计学意义(P<0.05)。结论 24 h动态心电图在诊断SSS中具有一定的临床应用价值,并能有效评估SSS类型,为后续的治疗提供可靠依据。Objective To investigate the application value of 24-hour dynamic electrocardiogram in the clinical diagnosis and type evaluation of sick sinus syndrome(SSS).Methods Totally 94 patients with SSS admitted to the 7th People's Hospital of Zhengzhou from October 2022 to November 2023 were selected as the observation group,and 96 healthy personnel who underwent physical examination during the same period were selected as the control group.24 h holter electrocardiogram was performed in both groups.The 24 h holter electrocardiogram heart rate(24 h total stroke volume,24 h average heart rate,minimum heart rate and maximum heart rate),the incidence of different types of SSS(types I,Ⅱ,Ⅲ and IV),and the longest duration of heart rate < 30 beats/min,< 40 beats/min and < 50 beats/min were compared between the two groups.Results The total stroke volume,average heart rate,minimum heart rate and maximum heart rate of 24 h in the observation group were(75 556.42±13.46) times,(45.61±8.34) times/min,(31.53±4.72) times/min and(89.34±24.80) times/min,respectively,which were lower than those in the control group(P<0.05).The incidence of type I,Ⅱ,Ⅲ and IV SSS in the observation group was 11 cases(11.70%) of type I,10 cases(10.63%) of type Ⅱ,13 cases(13.82%) of type Ⅲ and 11 cases(11.70%) of type IV.The detection rates of atrial,ventricular escape rhythm,ventricular tachycardia,atrial tachycardia,show-fast syndrom,junctional escape rhythm,ventricular arrest,sinoatrial block,sinus arrest(>2.0 s) and significant sinus bradycardia in observation group were higher than those in control group(P<0.05).The longest duration of heart rate < 30 beats/min,< 40 beats/min and < 50 beats/min in observation group were(8.12±1.21) s,(341.88±51.28) s and(8 876.47±1 331.47) s,respectively,which were higher than those in control group(P<0.05).Conclusion 24 h holter electrocardiogram has certain clinical application value in the diagnosis of SSS,and can effectively evaluate the type of SSS,and provide a reliable basis for the subsequent t

关 键 词：病态窦房结综合征 24 h动态心电图 诊断 

分 类 号：R541.74[医药卫生—心血管疾病]