摘要
对24小时动态心电图(DCG)检出有室性早搏(PVBs)的575例进行分析。分为器质性心脏病组(Ⅰ组)和无器质性心脏病证据组(Ⅱ组),两组分别为367例和208例。结果显示≥LownⅢ级以上的复杂性PVBs和≥30次/小时的频发性PVBs发生率以I组明显为高,且又以心肌梗塞、扩张性心肌病、急性心肌炎为突出。Ⅰ组中73例伴有充血性心力衰竭(CHF),其复杂性PVBs又显著高于心功能正常者,频发性PVBs的发生率与心功能无明显关系。47例同时检出室性心动过速(VT)共141阵次,其发生率Ⅰ组高于Ⅱ组,均呈短阵发作,自行终止。VT发作前多呈成对和/或多源形式出现。检出有RonT或RonP现象56例,RonP现象Ⅰ组明显多于Ⅱ组。RonT现象在两组间检出率无明显差异。由RonP现象诱发的成对PVBs或短阵VT远多于RonT者。同时伴发其他心律失常或传导障碍Ⅰ组也多于Ⅱ组。本文认为,复杂性及频发性PVBs和短阵室速以器质性心脏病者多发并与其心脏病变的严重程度和/或心功能状态有关。多源与/或成对PVBs同VT发生有密切联系,表明PVBs的Lown分级对室性早搏的病理意义判定仍有一定价值,但并不完全,本组有1/3的频发或?
The ventricular premature beats(PVBs)examined by 24 hdynamic
electrocardiogram( DCG)in 575 cases were analysed. According to clinical data, they were
divided into two groups: group 1(367 cases with cardiac disease) and group 2(208 cases
without cardiac disease)The incideceof the complicated PVBs(≥Lown′ s gradeⅢ)and frequent
PVBs(≥30 beats/h)in group l especially in cases with congestive heart failure(CHF),dilated
cardiomyopathy and acute myocarditis, was much higher than hat in group 2. In group l,the
incidence of complicated PVBs in 73 cases with CHF was much higher than the cases with
normalcardiac function,however, the incidence of frequent PVBs had no obvious relation to the
cardiac function. 141 episodes of ventriclar tachycardia(VT ) were found in 47 cases,most of
which began as paired and multifocally and occurred as short paroxysmally,stopped
spontaneouslly. RonT or RonP phenomena were detected in 56 cases. RonP phenomena in
group l as well as the other complicated arrhythmia or conduction disturbance occurred much
more than group 2, however the detectable rate of RonT phenomena between two groups had no
significant difference. In addition,the paired PVBs or short paroxysmal VT induced by RonP
phenomena occurred much more than that induced by RonT.Weconcluded that the complicatd
and frequent PVBs and paroxysmal VT occurred more in the cases with cardiac diseases than
the cases without cardiac diseases and had relation tothe severity and/or cardiac function of
the cases. The multifocal and/or paired PVBs had close relation to VT which indicated PVBs
and Lown′s classification was of certain value to the judgement of pathological significance of
PVBs. However,one third ofthe frequent or complicated PVBs had no proof of the cardiac
disease and a few of VT and RonT phenomena occurred in group Ⅱ. VT induced by RonP
occurred much more than RonT ,indicating that RonP phenomena was of much clinical
importance.
出处
《宁夏医学杂志》
CAS
1995年第5期257-260,共4页
Ningxia Medical Journal
关键词
心电图
心律失常
室性早搏
electrocardiography
arrhyth mia
premature ventricular beat
clinical
significance