病毒性心肌炎患儿动态心电图78例分析

Analysis of dynamic electrocardiogram of 78 children with viral myocarditis

目的:探讨病毒性心肌炎患儿的动态心电图表现特点,为病毒性心肌炎的诊断提供依据。方法:对78例病毒性心肌炎患儿的动态心电图检查结果进行回顾性分析。结果:78例患儿有5例动态心电图检测大致正常,73例有异常改变。73例异常中有各种心律失常者66例,占90.4%,伴ST段、T波改变的11例;仅有ST段、T波改变的7例,占9.6%。在各种心律失常中,以过早搏动为多见,其次是传导阻滞。同时有2种或2种以上心律失常或其他心电图改变者14例。24h动态心电图阳性检出率为93.59%(73/78),常规心电图的阳性检出率为60.26%(47/78),二者比较差异有统计学意义(P<0.05)。结论:儿童病毒性心肌炎的心电图表现呈多样性变化,24h动态心电图可更全面、客观、有效的反映其心电变化,从而为儿童病毒性心肌炎的早期诊断和及时治疗以及准确判断预后提供可靠地依据。

Objective： To discuss the features of dynamic electrocardiogram of children viral myocarditis,and to offer the basis for diagnosis.Methods： Clinical data of 78 children with viral myocarditis were analyzed retrospectively.Results： Five cases had normal result of dynamic electrocardiogram while the remaining revealed abnormal changes.There were 66 cases（90.4%） with arrhythmia,11 with ST segment or T wave changes,and 7 with only changes in ST segment and T wave（9.6%）.In patients with arrhythmias,premature beat was more common,followed by heart block.14 cases showed 2 or more than 2 kinds of arrhythmia or other ECG changes.The positive rate was 93.59% by 24-hour dynamic electrocardiogram while the positive rate was 60.26% by conventional ECG,with significant difference（P0.05）.Conclusions： The ECG of children with viral myocarditis is various,and 24-hour dynamic electrocardiogram may be more comprehensive,objective and effectively,It can provide reliable and accurate data for early diagnosis,and is helpful in curing the viral myocarditis and making prognosis.