心律失常患者医院感染前后心电图变化的临床对比研究

Clinical study on change of electrocardiogram of arrhythmia patients before and after being infected

目的探讨心律失常患者医院感染前后心电图变化,以期提高临床诊断治疗质量。方法回顾性分析2011年2月-2012年12月64例心律失常患者医院感染患者的临床资料,对所有患者进行心电图检查,观察病原菌与心电图的关系以及感染前后心电图的变化,采用SPSS13.0软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验。结果心律失常患者医院感染前房室期前收缩52例,占81.25%;感染后61例,占95.31%;室性期前收缩感染前为41例,占64.06%;感染后55例,占85.94%、束支阻滞感染前16例,占25.00%;感染后29例,占45.31%;窦性心动过速感染前19例,占29.69%;感染后33例,占51.56%,以上感染前后心电图的变化率差异有统计学意义(P<0.05);在心电图与医院感染病原菌关系方面,心律失常合并医院感染患者的主要的心电图改变是ST-T改变,占81.16%,而这其中肺炎链球菌和大肠埃希菌存在着异常P波、Q波、QS波等改变,分别占13.04%和5.8%,而其他的病原菌在以上的异常心电图中均为0。结论房室期前收缩、室性期前收缩、束支阻滞、窦性心动过速等心律失常患者医院感染前后心电图存在差异性,有助于临床诊断和辅助治疗。

OBJECTIVE To explore the change of electrocardiogram（ECG）of arrhythmia patients before and after being infected so as to improve the quality of clinical diagnosis and treatment.METHODS From Feb 2011to Dec 2012,the clinical data of 64arrhythmia patients with nosocomial infections were retrospectively analyzed,then all the patients received the electrocardiography,the correlation between the pathogens and ECG and the change of ECG were observed before and after being infected,the statistical analysis was performed with the use of SPSS13.0software,the measurement data were analyzed by using t-test,and the count data were analyzed by means of the chi-square test.RESULTS There were 52（81.25%）arrhythmia patients with atrioventricular contraction before being infected and 61（95.31%）cases after being infected;there were 41（64.06%）cases of ventricular contraction before being infected and 55（85.94%）cases after being infected;there were 16（25.00%）cases of bundle branch block before being infected and 29（45.31%）after being infected;there were 19（29.69%） cases of sinus tachycardia before being infected and 33（51.56%）cases after being infected,the differences in the change of ECG between before and after being infected were significant（P〈0.05）.In the regard of the relationship between the ECG and the pathogens causing nosocomial infections,the change of ST-T was the major change of ECG for the arrhythmia patients complicated with nosocomial infections,accounting for 81.16%;there were abnormal P wave,Q wave,and QS wave changes in the Streptococcus pneumoniae（13.04%）and Escherichia coli（5.8%）,while the rest of the pathogens showed no change in the above abnormal ECG.CONCLUSION There is difference in the ECG between the arrhythmia patients with atrioventricular contraction,ventricular contraction, bundle branch block,and sinus tachycardia before and after being infected,which is conducive to the clinical diagnosis and adjuvant therapy.