71例阵发性房性心动过速的动态心电图分析与探讨

ANALYSIS AND INVESTIGATION OF DCG IN 71 PATIENTS WITH PAROXYSMAL AURICULAR TACHYCARDIA

目的:探讨71例阵发性房性心动过速发生规律及其临床意义。方法 :应用动态心电图对71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:房性心动过速以冠心病发生率最高(49.3%);检出率随年龄增长而增加,老年组检出率最高,尤以男性发生率增加更为明显,与其他年龄组比较差异有统计学意义(P<0.01);老年组房性心动过速昼夜节律减弱。结论:冠心病患者受到心房肌缺血、缺氧、炎症、变性、纤维化等多种因素的影响,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,主要因素与心肌退行性病变引起心脏自律性、兴奋性及传导性发生改变有关;房性心动过速昼夜节律减弱,提示老年人房性心动过速多为病理性改变。

Objective： To investigate the occurrence regularity and clinical significance in 71 patients with PAT（Paroxysmal Auricular Tachycardia）. Method：The occurrence regularity and circadian rhythms in 71 patients with PAT were monitored and analyzed by DCG. Result：The occurrence rate of AT（Auricular Tachycardia） was the highest in patients with coronary disease（49.3%）. The detectable rate increased with the age increasing and that of the elderly group was the highest. The increase of occurrence rate in male patients were even more obvious,and there was a significant difference compared with other age groups（P 0.01）. The circadian rhythms of AT in the elderly group reduced. Conclusion：Affected by atrial myocardial ischemia, hypoxia, inflammation,denaturation and fibrillation,patients with coronary disease have different speed of atrial depolarization,which easily caused PAT. The detectable rate of PAT increased with the age increasing,and the major reasons are related to the changes in cardiac automaticity,excitatory and conductivity caused by atrial myocardial degeneration. The weakening of AT circadian rhythms indicates that AT in the elderly patients is mostly pathologic change.