动态心电图对病态窦房结综合征的诊断价值分析

Value of Dynamic Electrocardiogram in Diagnosis of Sick Sinus Syndrome

目的探讨动态心电图对于病态窦房结综合征(SSS)的诊断价值。方法对我院门诊及住院患者窦性心动过缓(心率<50次/min)者进行阿托品试验。选择75例阿托品试验阳性者做动态心电图检查、分析。同期健康体检者56例做对照。结果75例阿托品试验阳性者动态心电图检测符合24 h总心搏<80 000次且24 h最慢心率<40次/min、最快心率<90次/min者52例。而对照组无1例24 h总心搏<80 000次。部分并有窦性停搏(静止)、窦房阻滞、房室传导阻滞、慢快综合征、心室停搏、交界性逸搏及逸搏心律、期前收缩等心律失常。结论动态心电图可全面了解患者的心律和心率的变化,能明显提高心律失常的检出率,是早期诊断病态窦房结综合征的最可靠的方法。

Objective To explore the diagnostic value of dynamic electrocardiogram in patients with sick sinus syndrome （SSS）. Methods Atropine test was performed in sinus bradycardia outpatients and inpatients whose heart rates were 〈 50 times/min in People＇ s Hospital of Shimen County. 75 patients with positive results of atropine test were measured and analyzed by 24 hrs Holter monitoring, meanwhile, 56 healthy physical examinees were served as control subjects. Results Among 75 patients with positive results of atropine test, 52 patients＇ dynamic electrocardiogram showed that the 24 hrs total heart pulsation was 〈 80,000 beats, the slowest heart rate was 〈 40 beats/min in 24 hours, and the highest heart rate was 〈 90 beats/min in 24 hours. But no healthy physical examinees occurred that the total heart pulsation was 〈 80,000 beats in 24 hours. Arrhythmia, including sinus arrest （sinus standstill）, sino- auricular block, atrioventricular block, brady- tachycardia syndrome, ventricular standstill, junctional escape and junctional escape rhythm, extrasystole occurred in some patients. Conclusions Dynamic electrocardiogram can comprehensively understand the patient＇s cardiac rhythm and the change of heart rate, and significantly improve the detection rate of arrhythmias, which is the most reliable method in early diagnosis of SSS.