心肌缺血总负荷达标者室性期前收缩发生部位的研究

Incidence Regions of Premature Ventricular Beats in Patients with Total Ischemia Burden

目的对比研究心肌缺血总负荷(TIB)达标者与健康体检者室性期前收缩发生部位的差异。方法选择12导联同步动态心电图检测的235例室性期前收缩患者,其中TIB达标者125例、健康体检者110例,对比分析两组对象不同起源部位室性期前收缩发生率。结果 TIB达标者左心室前壁及心尖部期前收缩发生率分别为20.0%、13.6%,左心室期前收缩总发生率为50.4%,右心室流出道期前收缩发生率为32.0%、右心室期前收缩总发生率为49.6%;健康体检者左心室前壁及心尖部期前收缩发生率分别为3.6%、2.7%,左心室期前收缩总发生率为23.6%,右心室流出道期前收缩发生率为60.9%、右心室期前收缩总发生率为76.4%。TIB达标者左心室前壁及心尖部期前收缩发生率、左心室期前收缩总发生率明显高于健康体检者,差异有统计学意义(P<0.05);健康体检者右心室流出道期前收缩发生率、右心室期前收缩总发生率显著高于TIB达标者,差异有统计学意义(P<0.05)。结论 TIB达标者左心室前壁及心尖部期前收缩发生率、左心室期前收缩总发生率高于健康体检者;健康体检者右心室流出道期前收缩发生率、右心室期前收缩总发生率高于TIB达标者。判断室性期前收缩的临床意义要结合期前收缩发生部位。TIB达标者出现室性期前收缩时应及时监测电生理活动,同时要采取积极有效的治疗措施预防或处理威胁生命的恶性室性心律失常。

Objective To study the difference of premature ventricular beat incidence regions between total ischemia burden（TIB） patients and healthy subjects.Methods Two hundred thirty-five premature ventricular beat subjects receiving synchronism 12-lead dynamic electrocardiogram were enrolled,including 125 TIB patients and 110 healthy subjects.The incidences of premature ventricular beat from different origins were analyzed comparatively.Results In TIB patients,the premature systole incidences at anterior left ventricular wall and apex of heart were 20.0%,13.6%,respectively;the total incidence was 50.4%;the premature systole incidence of right ventricular outflow tract was 32.0%,total incidence was 49.6%.In healthy subjects,the premature systole incidences at anterior left ventricular wall and apex of heart were 3.6%,2.7%,respectively;the total incidence was 23.6%;the premature systole incidence of right ventricular outflow tract was 60.9%,total incidence was 76.4%.The incidence of premature systole at anterior left ventricular wall and apex of heart and total incidence was significantly higher in TIB patients than in healthy subjects（P〈0.05）.The premature systole incidence of right ventricular outflow tract and total incidence were higher in healthy subjects than in TIB patients（P〈0.05）.Conclusion The incidence of premature systole at anterior left ventricular wall and apex of heart and total incidence are significantly higher in TIB patients than in healthy subjects;the premature systole incidence of right ventricular outflow tract and total incidence are higher in healthy subjects than in TIB patients.Electrophysiology should be monitored timely when TIB patients present with premature systole,and effective treatment be taken and life-threatening malignant ventricular arrhythmias be dealt.