386例心脏病动态心电图监测分析.DOCVIP

临床医学论文-386例心脏病动态心电图监测分析 【关键词】? ,无症状性心肌缺血 ??? 　　摘???? 要：目的：探讨心脏病患者24h心电图的变化。方法：通过分析386例心脏病患者的24h动态心电图情况，分析其各类心脏病与心律失常相关性。结果：各种心脏病中最为常见的是出现房性心律失常，而冠心病、高血压心脏病的室性心律失常发生率最高，但心衰与室性心律失常之间差异无显著性(P0.15)，说明室性心律失常与左心功能减退无相关性。LOWN分级Ⅲ级以上室性心律失常易引发猝死。心房纤颤多见于风心病，其次为冠心病和肺心病；房室传导阻滞则多于病毒性心肌炎；无症状性心肌缺血（SMI），在冠心病、心绞痛中发生率较高。结论：24h动态心电图监测对心律失常评估有着很大意义。 　　关键词：???? 动态心电图；???? 心律失常；???? 无症状性心肌缺血 　　Analyse to Dynamic Electrocardiogram(DCG) of 386 Cardiopathy Patients 　　Abstract：Objective：To explore change rules of 24 hours dynamic electrocardiogram. Method：Monitoring results of DCG of 386 cardiopathy patients were analysed. Results：Incidence rate of atrial arrhythmia was the highest in all kinds of cardiopathys, but incidence rate of ventricular arrhythmia was the highest in coronary heart disease(CHD) and hypertensive cardiopathy. There were no significant difference between heart failure and ventricular arrhythmia(P0.15) and the results revealed there were not correlation between ventricular arrhythmia and left heart function failure. Ventricular arrhythmia patients who were Ⅲ grade of LOWN were apt to sudden death. atrial fibrillation usually occurred in rheumatic heart disease(RHD), CHD and pulmonary heart disease. Atrioventricular bundle usually occurred in virus myocarditis. Silent myocardial ischemia(SMI) usually occurred in CHD and angina pectoris. Conclusion：It had important significance that 24 hours dynamic electrocardiogram was used for assessing arrhythmia. 　　Key words：???? Dynamic electrocardiogram;???? Arrhythmia;???? Silent myocardial ischemia 　　心源性猝死的患者，多因存在复杂、恶性的心律失常或延误诊治，本文收集386例心脏病患者24h动态心电图，就其临床和心电图分析，旨在探讨各种心脏病与心律失常的关系和其临床意义。 　　1???? 资料和方法 　　1.1???? 检查对象：本组对1990年至2004年386例为门诊或住院患者，临床诊断为：冠心病168例，心肌梗死32例，高血压心脏病79例，病毒性心肌炎11例，慢性肺心病5例，风心病29例，病态窦综合征10例，其中男278例，女98例，年龄19～82岁（平均63.5岁）。 　　1.2???? 方法：采用美国DMSODTWARE公司产MGY-H7型动态心电图仪检测，选用标准导联A（7）三通导心电信号，在24h监测后闪光卡回放分析。 　　1.3???? 统计学处理：采用卡方检验，P0.05为差异有显著性意义。 　　2???? 结???? 果 　　2.1???? 各类心脏病心律失常发生率分布：表1可见房性心律失常发生率居高，次为室性心律失常。 　　2.2???? 各