常规心电图与动态心电图检测对小儿心律失常及心率变异性诊断价值比较

Comparison of the diagnostic value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children

目的 比较常规心电图与动态心电图在小儿心律失常及心率变异性诊断中的应用价值.方法对收治的小儿心律失常患儿分别采取常规心电图与动态心电图检查,比较两种检查方法对心律失常的检出率,并分析小儿心律失常与心率变异性之间的关系.结果 动态心电图在室上性心动过速（13.33%）、室性心动过速（5.56%）、室性期前收缩（21.11%）、房性期前收缩（14.44%）、传导阻滞（12.22%）等心律失常检出率均明显优于常规心电图检查,差异均有统计学意义（χ^2=11.93、4.56、9.22、10.74、11.55,均P〈0.05）.室性心律失常患儿的心率变异性与非室性心律失常患儿相比较[（78.85±0.88）、（4.68±2.43）、（24.78±2.56）、（21.66±0.94）]差异有统计学意义（t=10.88、11.79、9.84、9.92,均P〈0.05）.结论 与常规心电图相比,动态心电图对于小儿心律失常具有较好的诊断价值,对室上性心动过速、室性心动过速、室性期前收缩、房性期前收缩、传导阻滞等心律失常检出率具有明显优势,而且其测定心率变异性有助于评估病情.

Objective To compare the application value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children.Methods In our hospital,pediatric arrhythmia patients were given routine electrocardiogram and dynamic electrocardiogram.The relationship between arrhythmia and heart rate variability in children was analyzed.Results Supraventricular tachycardia （13.33%）,ventricular tachycardia（5.56%）,premature ventricular contraction （21.11%）,premature atrial contraction （14.44%）,block （12.22%） in the dynamic electrocardiogram were significantly better than the conventional electrocardiogram,and the differences were statistically significant χ^2=11.93,4.56,9.22,10.74,11.55,all P〈0.05）.There were significant differences in the heart rate variability between ventricular arrhythmias and non-ventricular arrhythmias in children[（78.85±0.88）,（4.68±2.43）,（24.78±2.56）,（21.66±0.94）, t=10.88,11.79,9.84,9.92,all P〈0.05].Conclusion Compared with routine electrocardiogram, dynamic electrocardiogram has better diagnostic value for pediatric arrhythmia of ventricular tachycardia.The detection rate of ventricular tachycardia,ventricular tachycardia,premature ventricular contraction,atrial premature contraction,conduction block and other arrhythmias are obviously superior.And dynamic ECG measurement of heart rate variability is helpful to assess the severity of the disease.