动态心电图检测在老年人中的应用价值

Application value of ambulatory electrocardiogram detection in eldely patients

目的运用十二导联动态心电图对老年患者检测分析，探讨心肌缺血以及心律失常规律特点，明确动态心电检测在老年人中的应用及应用价值。方法回顾性分析940例老年患者24h十二导联动态心电图资料。心肌缺血分为有症状和无症状心肌缺血。心律失常按窦性心律失常、房性心律失常、室性心律失常、房室传导阻滞、束支阻滞归类进行统计。结果心肌缺血随着老年患者增龄差异有统计学意义（P〈0．01）。心律失常的发生率相当高，以房性期前收缩、室性期前收缩为最多见，心律失常随着年龄的增长差异有统计学意义（P〈0．05）。结论老年患者行24h动态心电图监测可以有效捕捉ST段改变和心律失常，为临床诊断和治疗提供有效的依据，避免心肌缺血和恶性心律失常的发生。

Objective By detecting and analyzing the elderly patients with 12-lead ambulatory electrocardiogram, and by observing and studying myocardial ischemia and arrhythmia occurred within 24 hours, to investigate the features and patterns of ambulatory electrocardiogram detection and to confirm its application value in the elderly patients. Methods A retrospective analysis of 940 cases of elderly patients detected by 24-hour 12-lead ambulatory electrocardiogram was made. Myocardial isehemia was divided into symptomatic myocardial ischemia and silent ischemia. Arrhythmia was classified and added up as sinus arrhythmia, Atrial arrhythmia, ventricular arrhythmias, atrioventrieular block, bundle branch block. Results Myocardial ischemia had significant difference with the increase of patients＇ age （P 〈 0. 01 ）. The occurrence of arrhythmia was very high, and premature atrial contraction and premature ventrieular contraction were the most common. There was significant difference of arrhythmia with age. Conclusions Compared with routine electrocardiogram, the 24-hour ambulatory electrocardiogram is effective in detecting arrhythmia and momentary ST change. It is easy to make qualitative and quantitative analysis with ambulatory electrocardiogram, which can provide effective basis for clinical diagnosis and treatment, to avoid the occurrence of myocardial and malignant arrhythmias.