动态心电图对监测室性心动过速分析及临床意义

Characteristics and clinical significance of ventricular tachycardia： analysis of 1920 cases

目的应用24h动态心电图检查探讨室性心动过速发生的特点及临床意义。方法回顾性分析动态心电图检查出的室性心动过速患者90例图形资料。结果90例患者中动态心电图共检测出室性心动过速1203次，室性心动过速发作室率为73～250次／min其中24h内发生一阵室性心动过速的69例（76．6％）。78例基础心率为窦性心律（86．6％）。单源性室速73例（81．1％），多源性室速17例（18．9％）。室速发生时有头晕心悸胸闷气短等86例（95．5％）。90例患者中同时伴有sT—T改变者79例（87．7％）。90例患者87例为非持续性室速，3例为持续性室性心动过速，均为自行终止。随访中5例死亡，3例为心肌缺血发生室颤而猝死。结论室速的发生与器质性心脏病合并高血压、心肌缺血、心力衰竭、心律不齐、电解质紊乱等密切相关，及时去除病因，积极治疗原发病，大多数室速均可转好。

Objective To analyze the charactgeristics and clinical significance of ventricular tachycardia （VT）. Methods Dynaimc electromyocardiography （DEG） was used to record the 24-h ECG of 1920 randomly selected in-patients. The clinical data thus collected of 90 patients with VT, 68 males and 22 females, aged 77.3 （46-96）, 62 with coronary heart diseases, 13 with hypertensive heart disease, 8 with hypokalemia. 2 with rheumatic heart disease, 1 with dilated cardiomyophathy, 1 with uremis, 4 with cerebrovescular diseasea, 4 with pulmonary heart diseases, and 5 with unknown caauses, were analyzed by computer. Results 1203 times of VT were detected with the ventricular rates of 73-250 times/min. 69 cases （76.6%） were recorded with only one episode of VT during 24h. The basic ventricular rhythm of 78 cases （86.6%） was sinusoid rhythm. Unifocal VT was seen in 73 cases （81.1）, and muhifocal VT in 17 cases （18.9%）. Symptoms of diziness, palpitation, breast distress, and short berath occurred during VT attack in 86 cases （95.5%）. ST-T changes were seen in 79 cases （87.7%）. The VT was non-pertinent in 87 cases, and pertinent in 3 cases. The VT automatically terminated in all patients. 3 patients died during the follow-up, 3 of which died of ventricular fibrillation caused by myocardial ischemia. Conclusion VT is associated with heart disesses complicated with hypertension, nyocardial ischemia, hypokalemia, etc.