动态心电图在小儿心律失常与心率变异性诊断中的意义

The Value of Dynamic Electrocardiogram in Diagnosis of Pediatric Cardiac Arrhythmias and Heart Rate Variability

目的:研究动态心电图(DCG)诊断小儿心律失常及心率变异性(HVR)的临床价值。方法:560例患者均进行常规心电图和动态心电图的检查,由两组专业人员分别对心电图(ECG)和动态心电图(DCG)的检查结果进行(评价),比较两种检查手段的不同类型的心律失常的诊出率;评价不同类型心律失常的HVR。结果:ECG对各型心律失常的总诊出率为25.00%,对不同类型心率失常的诊出率分别为5.71%、1.43%、9.29%、6.43%和2.14%;DCG总诊出率为62.85%,对不同类型心率失常的诊出率分别为16.43%、6.43%、17.86%、14.29%和7.86%,二者具有统计学差异(P<0.05)。不同类型的心律失常的HVR不同,其中室性心动过速和室性期前收缩的各项指标均明显低于其他类型(P<0.05)。结论:DCG对不同心律失常的诊出率明显高于ECG,并能有效反应不同类型心率失常的HVR,在小儿心律失常的诊断中具有一定的临床价值。

Objective： To study the clinical value of dynamic electrocardiogram（DCG） in diagnosis of pediatric arrhythmia and heart rate variability（HVR）. Methods： A total of 560 cases of patients were given routine electrocardiogram and dynamic electrocardiogram inspection. Two groups of professionals gave the evaluation and assessment of ECG and DCG test results. The detection rates of arrhythmia examined through the two methods were compared, and different types of arrhythmia in HVR were evaluated. Results： The overall diagnosis rate of various types of arrhythmia was 25% by ECG, and the detection rates of different types of arrhythmia by ECG were 5.71%, 1.43%, 9.29%, 6.43% and 2.14%. The overall detection rate was 62.85% by DCG, and the detection rates of different types of arrhythmia by DCG were 16.43%, 6.43%, 17.86%, 14.29% and 7.86%. There were statistically significant differences between the two methods（P〈0.05）. HVR of different types of arrhythmia was different. The indexes of ventricular beckoning and ventricular systolic velocity were obviously lower than those of other types（P〈0.05）. Conclusion： The diagnosis rate of different arrhythmia through DCG was significantly higher than that by ECG, and it is of effective response to the HVR of different types of arrhythmia. Therefore, it has clinical values in the diagnosis of arrhythmia in children.