动态心电图检查对扩张型心肌病临床诊断价值分析

Application value of Holter in clinical diagnosis and treatment of dilated cardiomyopathy

目的:分析动态心电图检查在扩张型心肌病诊治的作用及价值。方法:选取2013年1月-2014年12月经心脏超声检查诊断为扩张型心肌病患者65例作为研究对象,对其进行24 h的动态心电图监测,观察其应用效果。结果:65例扩张型心肌病患者均出现心律失常,所表现类型分别为室性早搏、ST-T改变、QTc延长、房室早搏、室性心动过速、心房颤动、房性心动过速、房室传导阻滞、左束支阻滞、窦性心动过速,所占比例分别为92.3%,69.2%,58.5%,43.1%,33.8%,27.7%,24.6%,23.1%,23.1%,15.4%;心功能分级Ⅱ级、Ⅲ级、Ⅳ级中心律失常所占比例分别为40.9%,57.6%,70.0%。结论:扩张型心肌病患者其动态心电图表现呈现多样性,且心律失常情况比较严重。心功能越差,患者出现心律失常的情况就越多。临床中应用动态心电图具有较好的诊断效果,临床实际应用价值高。

Objective： To investigate the role and value of Holter in diagnosis and treatment of dilated cardiomyopathy. Methods： 65 cases of dilated cardiomyopathy patients from our hospital from January 2013 to December 2014 were selected as the study objects. All the cases were monitored 24 hours by dynamic electrocardiogram and the application effect was observed. Results： Arrhythmia was detected in all the 65 cases,with demonstrations such as premature ventricular contractions,ST-T change,QTc prolongation,auricular premature beat,ventricular tachycardia,auricular fibrillation,auricular tachycardia,atrioventricular block,left bundle branch block,and sinus tachycardia,with proportions 92. 3%,69. 2%,58. 5%,43. 1%,33. 8%,27. 7%,24. 6%,23. 1%,23. 1%,and15. 4% respectively. According to classification of NYHA,arrhythmia in grades II,III and IV accounted for 40. 9%,57. 6%,70. 0%respectively. Conclusion： The demonstrations of dilated cardiomyopathy in dynamic electrocardiogram diverse,and the situation is more serious with arrhythmia. The worse the cardiac function is,the more possible the patient＇s arrhythmia. Application of dynamic electrocardiogram is preferred because of its better diagnosis and treatment effect and high clinical practical value.