短阵房性心动过速发生规律及其昼夜节律的临床意义

Clinical value of the regularity of outbreak and the diurnal rhythm of paroxysmal atrial tachycardia

目的探讨短阵房性心动过速发生规律及其昼夜节律的临床意义。方法应用动态心电图对366例短阵房性心动过速发生规律及其昼夜节律进行监测与分析。结果短阵房性心动过速以冠心病的发生率最高(55.2%);检出率随年龄增长而增加,老年组检出率最高,与其他年龄组比较差异有统计学意义(P<0.01);房性心动过速发作存在昼夜节律(2个高峰和1个低谷)。结论冠心病患者受到心房肌缺血、缺氧、炎症、变性、纤维化等多种因素影响,使心房肌除极速度不一致,利于短阵房性心动过速的发生;短阵房性心动过速的检出率随年龄增长呈上升趋势,主要因素与心房肌退行性变引起心脏自律性、兴奋性及传导性发生改变有关;短阵房性心动过速存在昼夜节律,提示受植物神经的影响。

Objective To explore the clinical value of the regularity of outbreak and the diurnal rhythm of paroxysmal atrial tachycardia. Methods The DCG was used to analyse the regularity of out- break and the diurnal rhythm of paroxysmal atrial tachycardia in 366 patients. Results The incidence rate of paroxysmal atrial tachycardia was the highest in patients with coronary heart disease （ 55.2% ）, and the rates was increased by age increasing, the elder group was the highest while compared with other groups（P 〈0.01 ）. The diurnal rhythm was found on those with paroxysmal atrial tachycardia. Conclu- sion Atrium muscle depolarization velocity incongruous on patients with coronary heart disease is favora- ble for the incidence of paroxysmal atrial tachycardia affected by myocardial ischemia, hypoxia, inflam- mation, denaturalization and fibrosis. Detection rate is increased by age increasing which is result from the changing of automaticity, excitory, conductibility of the heart induced by myocardial degenerative. The diurnal rhythm of paroxysmal atrial tachycardia was proved to been effected to by vegetative nerve.