重型室性早搏的节律周期性及与心率的关系

Circadian variation of severe ventrkular premature beat and its relationship to heart rate

为探讨和评价重型室早的节律周期性及与心率的关系,对70例伴有重型室早(≥Lown-WolfⅢ级)患者的动态心电图进行分析,发现:①室早分布类型以均匀型(56.16%)和单峰型(72.80%)最为常见,但各组无显著性差异(P>0.05);②室早分布的最大比率和室早高峰时间在心脏病组均常见于06:01—12:00时段(38.10%和42.86%),而在对照组均常见于12:01—18:00时段(50%和57.14%),两组有显著性差异(P<0.05);③室早与心率在心脏病组以正相关和不相关多见(均为42.86%),在对照组以负相关多见(50%),两组有非常显著性差异(P<0.01);④24h室早数量和级别在心脏病组和对照组无显著性差异(P>0.05).上述特点对于判定重型室早的临床意义和选用抗心律失常药物有一定的参考价值.

To explore and evaluate circadian variation of severe ventricular premature beat (PVC) and its relationship to heart rate, 70 patients (38 men and 32 women, mean age 41 years) with severe PVC(Lown-Wolf grade≥3), 42 cases had documented heart disease (heart disease's group, HDG). 28 cases had no heart disease (control group, CG) and 22 cases were administered with antiar-rhythmic drugs (therapeutic group, TG), and 48 cases' recordings had been done after withdrawl of all antiarrhythmic drugs for at least 5 half-lives (non-therapeutic group, NTG), Result showed that severe PVC had following features: (1) In PVC distribution there were average pattern (58. 43%) and monopeak pattern (72. 80%) in most cases, but there was no significant difference between each coupling groups (P>0. 05), (2) Largest distribution ratio and peak time of PVC were from de tected at 6Am to 12Am in most HDG cases (38. 10% and 42. 86% respectively), but 12Am to 6Pm in most cases of CG (50% and 57. 14% respectively), with significant difference between two groups ( P<0.05). (3) Correlation coefficient ( r ) of relationship between PVCs/h and average heart rate/h ranged from -0. 88 to +0. 87 in this study. Positive correlationship ( r≥0. 404) and irrelevance (-r = - 0. 403-0. 403) were found in most HD cases (both 42. 86%). Negative correlationship ( r≤-0. 404) was seen in most of GG cases (50%). There was a significant difference in irrelevance and negative correlation ship between two groups ( P<0. 01). (4)HDG and CG were similar in number and grade of PVCs/24h( P>0. 05). Above features are of clinical significance and helpful in determinating severe PVC and selecting antiarrhythmic drugs against it.