动态心电图对慢性肺源性心脏病的诊断价值分析

Analysis of the Value of Dynamic Electrocardiogram in the Diagnosis of Chronic Pulmonary Heart Disease

目的:探讨动态心电图对慢性肺源性心脏病的诊断价值。方法:入选98例慢性肺源性心脏病患者及100例无呼吸系统及心血管系统疾病患者,分别作为研究组与对照组,均在入院后1~2 d上午8:30行24 h动态心电图监测,比较两组ST段改变、心率失常、心率震荡(HRT)指标、心率变异性(HRV)时域指标。结果:与对照组相比,研究组ST段压低或抬高的比例、ST段压低位移幅度及持续时间、ST段抬高位移幅度、窦性心动过缓(SB)、室性早搏(VPB)、加速性室性自主心率(AIR)、室颤(VF)的发生率、震荡初始(TO)、动态心率震荡(TD)均明显升高(P<0.05),震荡斜率(TS)、总体标准差(SDNN)及均值标准差(SDANN)明显低于对照组(P<0.05)。结论:动态心电图可比较准确地检查出慢性肺源性心脏病患者心肌缺血、心律失常、HRT、HVR等方面的异常,在诊断慢性肺源性心脏病方面具有重要参考价值。

Objective： To investigate the value of dynamic electrocardiogram in the diagnosis of chronic pulmonary heart disease.Methods： 98 cases of patients with chronic pulmonary heart disease and 100 cases of patients without respiratory and cardiovascular diseases were enrolled as the study group and the control group individually, and were monitored by 24 h dynamic electrocardiogram after admission within 1~2 d at 8：30 am. The changes of ST segment, heart rate variability, heart rate turbulence（HRT） and heart rate variability（HRV） were compared between the two groups. Results： Compared with the control group, the ST segment depression or elevation ratio, displacement amplitude, duration, the incidence of sinus bradycardia（SB）, ventricular premature beat（VPB）, accelerated solid heart rate（AIR）, high degree atrioventricular block（AVB）, paroxysmal ventricular tachycardia（PVT） of study group were significantly increased（P〈0.05）. The initial shock（TO）, dynamic heart rate turbulence（TD）, shock slope（TS）, total standard deviation（SDNN） and mean standard deviation（SDANN） of study group were significantly lower than those of the control group（P〈0.05）.Conclusion： The dynamic electrocardiogram can be used to check the abnormality of myocardial ischemia, arrhythmia, HRT and HVR in patients with chronic pulmonary heart disease accurately, and it is of important reference value in the diagnosis of chronic pulmonary heart disease.