动态心电图与常规心电图对冠心病心律失常的诊断价值比较

Comparison of the diagnostic value of dynamic electrocardiogram and routine electrocardiogram in coronaryheart disease

目的比较动态心电图与常规心电图对冠心病心律失常的诊断价值。方法选择2015年10月至2016年9月诊治的冠心病心律失常患者97例为研究对象，并对其同时进行动态心电图和常规心电图检查，对诊断结果进行统计学对比分析。结果（1）动态心电图对冠心病心律失常患者的检出率是87．63％，常规心电图检出率是74．23％，两种方法检出率差异有统计学意义（X2=5．644，P〈0．05）；（2）动态心电图、常规心电图对冠心病心律失常患者中房性早搏早发、室性早搏早发、室速的检出率差异均无统计学意义（X2=0．084、0．534、3．705，均P〉0．05）；动态心电图对患者房性早搏成对、室性早搏成对、心房颤动、短阵室上速、房性早搏二、三联律以及室性早搏二、三联律的检出率，均高于常规心电图，差异均有统计学意义（X2=20．541、35．877、4．040、26．891、19．282、18．281，均P〈0．05）。结论与常规心电图相比，动态心电图对冠心病心律失常的诊断价值更高，可准确检测出患者的任意时间点冠状动脉缺血情况、心律失常发作频率以及发作时间，能够精细而准确地监测患者的心电信号，确定患者心律失常具体类型，为临床医师合理制定治疗方案提供依据。

Objective To discuss the diagnostic value.of dynamic electrocardiogram （ECG） and conventional ECG on cardiac arrhythmia of coronary heart disease （CHD）. Methods 97 CHD patients with cardiac arrhythmias were selected as study objects. All the patients received dynamic ECG and conventional ECG inspection. The diagnosis results were statistically analyzed. Results （ 1 ） The detection rate of dynamic ECG for cardiac arrhythmia was 87.63% ,which of conventional ECG was 74.23%, and the difference was statistically significant （X2 = 5. 644, P 〈 0. 05 ）. （2） The detection rates of premature atrial beats and early onset, premature ventricular beats and early onset, ventricular tachycardia between dynamic ECG and conventional ECG had no statistically significant differences （ X2 = 0. 084,0.534,3. 705 ,all P 〉0.05）. The detection rates of dynamic ECG for atrial premature beat,ventricular prema- ture beat, atrial fibrillation, short array supraventricular speed, two or three joint rhythm of atrial premature beat and two or three couplet rhythm of ventricular premature beat, were higher than conventional ECG, and the differences were statistically significant （ X2 = 20. 541,35. 877,4. 040,26. 891,19. 282, 18. 281, all P 〈 0. 05 ）. Conclusion Compared with the conventional ECG, dynamic ECG has higher value in the diagnosis of CHD with cardiac arrhythmia, which can accurately detect the coronary ischemia, arrhythmia seizure frequency and time, accurately monitor patients＇ ECG signal, determine the specific type of cardiac arrhythmias,thus to provide evidence for treatment.