老年风湿性心脏病患者的心电图特征分析及其临床意义

ECG Characteristics of the Elderly with Rheumatic Heart Disease and the Clinical Significance

目的分析老年风湿性心脏病患者的心电图特征表现,为该病的诊断和治疗效果的评价提供参考方法。方法选取2017月1月—2018年1月确诊的64例老年风湿性心脏病患者作为观察对象(观察组),把同期体检的50例健康老年人设为对照组。对比分析观察组和对照组心电图表现。根据是否发生房颤将观察组患者分为房颤亚组和窦性心律亚组,比较2亚组性别、年龄、瓣口面积、心功能分级和心脏增大等一般情况。结果观察组心电图异常发生率显著高于对照组(100.00%vs 38.00%,P<0.01)。观察组窦性心律显著低于对照组(P<0.01)。观察组患者中房颤、左心房增大、右心房增大、室内传导阻滞发生率显著高于对照组(P<0.01)。与窦性心律亚组比较,房颤亚组年龄、心功能III～IV级和心房室均增大的病例百分率均显著增加(P<0.01)。结论对于病因不明的房颤等心律失常患者,应怀疑风湿性心脏病的可能,要高度关注。

Objective To analyze the electrocardiogram(ECG)characteristics of the elderly with rheumatic heart disease so as to provide reference for the diagnosis and curative effect evaluation.Methods 64 elderly with confirmed diagnosis of rheumatic heart disease during the period from Jan.,2017 to Jan.,2018 were enrolled in observation group while 50 healthy elderly of physical examination during the same period were selected to be the control;a contrast study between the 2 groups was made to the ECG characteristics of the elderly;the elderly in observation group were further divided,based on the occurrence of atrial fibrillation,into 2 subgroups:atrial fibrillation subgroup and sinus rhythm subgroup,and their general information including gender,age,valve area,cardiac function classification and cardiac enlargement were comparatively studied.Results The incidence of abnormal ECG in observation group was significantly higher than that in control group(100.00%vs 38.00%,P<0.01)while the sinus rhythm in observation group was much lower than that in control group(P<0.01);the incidences of atrial fibrillation,left atrial enlargement,right atrial enlargement and ventricular block in observation group were significantly higher than those in control group(P<0.01);the average age and the case numbers of grade III-IV cardiac function and atrioventricular enlargement in atrial fibrillation subgroup were older and bigger than those in sinus rhythm subgroup(P<0.01).Conclusions High suspicion of rheumatic heart disease should be given to cases with arrhythmia due to atrial fibrillation of unknown etiology and more attention needs to be paid.