不明原因晕厥患者40例动态心电图分析

Dynamic electrocardiogram analysis of 40 patients with unexplained syncope

目的探讨动态心电图（dynamic electrocandiography,DCG）对不明原因晕厥的诊断价值及其临床意义。方法选择2004年1月至2012年3月在该院应用动态心电图进行分析诊断的晕厥患者40例,其中男28例,女12例;年龄26~70岁,平均49.5岁,病程2天至8年,平均9.5个月。所有患者均出现不同程度的黑蒙、晕厥,最长者达数分钟;采用北京美高仪公司与美国DM SOFTWARE公司合作的Holter 12.TOP版动态心电图仪进行检查,根据记录期间晕厥与否,将患者分为晕厥组与无晕厥组,记录结果采用电脑和人工回放进行分析判断。结果 40例患者经动态心电图检查,其中5例（12.5%）在记录中出现晕厥,与心律失常有关,尤其与R-R间期的长短有一定的相关性,晕厥组与无晕厥组比较,差异有统计学意义（P〈0.01）。结论一些不明原因晕厥的发作与心律失常密切相关。动态心电图检查可为不明原因晕厥患者提供重要的临床鉴别诊断依据。

Objective To increase the diagnosis of the dynamic electrocardiogram（Hoher） in unexplained syncope and its significance. Methods 40 cases of unexplained syncope diagnosed by 24 h dynamic electrocardiogram examination in our hospital from January 2004 to March 2012,28 males and 12 females, aged 26-70 years （average 49 years）, disease course 2 days -8 years （average 9.5 months） ,were selected. All cases had different degrees of amaurosis and syncope with the longest of over several minites. Results Among 40 cases detected by dynamic electrocardiogram, 5 cases （12.5%） had syncope episode, which was related with the heart rhythm, especially with R-R interval. Comparing the syncope group with the non-syncope group showed statistical difference（P〈0.001 ）. Conclusion Some unexplained syncope episodes are closely related with arrhythmias. Dynamic electrocardiogram exxamination may provide important clinical differentiating diagnostic basis for unexplained syncope.