动态心电图与常规心电图在冠心病患者心肌缺血及心律失常诊断中的应用价值

A comparison of dynamic electrocardiogram and routine electrocardiogram in diagnosis of myocardial ischemia and arrhythmia of patients with coronary heart disease

目的探讨动态心电图(dECG)与常规心电图(rECG)在冠心病(CHD)患者心肌缺血及心律失常诊断中的应用价值。方法 CHD患者85例,分别接受rECG和dECG检查,比较两者对CHD心肌缺血和心律失常的检出率。结果 rECG心肌缺血诊断的阳性率为51.76%(44/85),低于dECG的81.18%(69/85)(P<0.05);在心律失常的诊断上,dECG检测室性期前收缩二、三联律、房性期前收缩二、三联律、室性成对期前收缩、房性成对期前收缩、短阵室上性心动过速以及房室传导阻滞的阳性率均高于rECG(P<0.05),而在诊断频发室性期前收缩和频发房性期前收缩上,两种检测方法的阳性率相仿(P>0.05)。结论 dECG检查对CHD的早期诊断,尤其是无症状型CHD的早期诊断,具有重要的意义;rECG与dECG联合检查能够为CHD的诊断和治疗提供更为全面的帮助。

Objective To compare the value of dynamic electrocardiogram（dECG） and routine electrocardiogram（rECG） in the diagnosis of myocardial ischemia and arrhythmia of patients with coronary heart disease（CHD）. Methods The examinations of rECG and dECG were performed in 85 patients with CHD. The detection rates of myocardial ischemia and arrhythmia were compared. Results The positive diagnosis rate of myocardial ischemia was higher by dECG than that by rECG（81.18% vs. 51.76 %） （P〈0. 05）. The detection rates of ventricular extrasystole, triple two law, premature atrial contraction, bigeminy, ventricular two pairs of systole, atrial systole, paired paroxysmal supraventricular heartbeat tachycardia and atrioventricular block were higher by dECG than those by rECG（P〈0. 05）. The detection rates of frequent ventricular premature contraction and frequent premature atrial contraction by dECG and rECG were similar （P〉0. 05 ）. Conclusion dECG examination plays an important role in early diagnosis of CHD, especially in the patients with asymptomatic CHD. Combined examinations of rECG and dECG is helpful in early diagnosis and treatment of CHD.