运用动态心电图检测评价心肌缺血伴室性期前收缩起源部位的意义

Significance of applying dynamic electrocardiogram for evaluating original site of myocardial ischemia with ventricular premature contraction

目的运用动态心电图检测分析心肌缺血伴室性期前收缩患者各起源部位的发生率及临床意义。方法选取收治的300例心肌缺血伴室性期前收缩患者列为观察组,选取同期296例体检健康伴室性期前收缩人群列为对照组,两组均进行12导联同步动态心电图24h检测。对比两组研究对象左心室和右心室各起源部位期前收缩的情况;分析观察组患者不同心室起源部位期前收缩的发生率与心肌缺血的关系。结果观察组左心室前壁、心尖部及左心室总期前收缩发生率明显高于对照组,对照组右心室流出道及右心室总期前收缩发生率明显高于观察组患者,同时观察组患者左心室前壁及心尖部期前收缩发生率高于右心室前壁及心尖部,右心室流出道期前收缩发生率高于左心室流出道,差异均有统计学意义(P<0.05)。结论动态心电图可以有效检测评价心肌缺血伴室性期前收缩患者期前收缩不同起源部位,其中左心室前壁及心尖部期前收缩容易合并发生心肌缺血,同时对于心肌缺血早期临床诊断治疗及预后,提供重要的临床价值依据。

Objective To apply the dynamic eleetrocardiogram（ECG） to analyze the incidence and clinical significance of various original sites in the patients with myocardial ischemia complicating ventricular premature contraction（VPC）. Methods A total of 300 cases of myocardial ischemia complicating VPC in our hospital were selected as the observation group,and contemporaneous 296 healthy people with ventricular premature contractions were selected as the control group. The two groups were performed the ex- amination of 24 h 12-lead dynamic electrocardiogram. The relationship between the VPC occurrence rate at different ventricular o- riginal sites and myocardial ischemia was analyzed. Results The occurrence rates of total premature contraction at left ventricular anterior wall, apical site and left ventricle in the observation group were significantly higher than those in the control group; the to- tal premature contraction occurrence rates at right ventricular outflow tract and right ventricle in the control group were significant- ly higher than those in the observation group,meanwhile premature contraction occurrence rates at left ventricular anterior wall and apical site in the observation group were higher than those at right ventricular anterior wall and apical site,which at right ventricu- lar outflow tract was higher than that at left ventricular outflow tract,the differences were statistically signifieant（P〈0.05）. Conclusion Dynamic ECG can effectively detect and evaluate different original sites of premature contraction in the patients with myo- cardial ischemia complicating VPC,in which the premature contraction at left ventricular anterior wall and apical site is easier to develop complicating myocardial ischemia,meanwhile which provides the important clinical value basis for early diagnosis, treatment and prognosis of mvocardial ischomia