风湿性心脏病伴长RR间期的心内电生理研究

Intracardiac Electrophysiological Study of Rheumatic Heart Disease With Long RR Interval

目的探讨风湿性心脏病心房颤动伴长RR间期的心内电生理情况。方法选取2016年8月—2017年8月我院收治的风湿性心脏病心房颤动伴长RR间期患者68例作为研究对象。所有患者均经冠状动脉造影检查确诊(金标准),患者入院后先拟行彩色多普勒超声检查,检查完毕后行心内电生理检查,将彩色多普勒超声检查与心内电生理检查结果与金标准进行比较;比较彩色多普勒超声检查与心内电生理检查下患者右房容积(LAD)、右室容积(RVV)、左室容积(LVV)、左心房舒张末期直径(LAD)情况、心脏瓣膜情况,记录所有患者最慢心率、最快心率、平均心率、RR间期。结果所有患者均经金标准确诊,彩色多普勒超声检查最终确诊60例,诊断符合率为88.24%,与金标准比较,差异具有统计学意义(P <0.05);心内电生理检查最终确诊66例,符合率为97.06%,与金标准比较,差异不具有统计学意义(P> 0.05);心内电生理检查诊断符合率高于彩色多普勒超声检查结果,差异具有统计学意义(P <0.05);心内电生理组LAD、RVV、LAD高于彩超组,差异具有统计学意义(P <0.05);心内电生理组LVV低于彩超组,差异具有统计学意义(P <0.05);心内电生理组心脏瓣膜各指标高于彩超组,差异具有统计学意义(P <0.05)。结论风湿性心脏病心房颤动伴长RR间期检查过程中,心内电生理的检查效果满意。

Objective To investigate the intracardiac electrophysiological condition of rheumatic heart disease with atrial fibrillation and long RR interval.Methods 68 cases of patients with rheumatic heart disease and atrial fibrillation with long RR interval were selected as the study subjects from August 2016 to August 2017.All patients were confirmed by coronary angiography (gold standard).After admission,color Doppler ultrasonography was planned.Intracardiac electrophysiological examination was performed after the examination.The results of color Doppler ultrasonography and electrophysiology were compared with the gold standard.The right atrial volume (LAD),right ventricular volume (RVV), left ventricular volume (LVV),left atrial end diastolic diameter (LAD) and heart valves were compared between color Doppler echocardiography and electrophysiological examination.The slowest heart rate,the fastest heart rate,the average heart rate and RR interval were recorded.Results All patients were diagnosed by gold standard,and 60 cases were finally diagnosed by color Doppler ultrasonography.The diagnostic coincidence rate was 88.24%.Compared with gold standard,the difference was statistically significant (P<0.05).66 cases were finally diagnosed by intracardiac electrophysiological examination,the coincidence rate was 97.06%.Compared with the gold standard,the difference was not statistically significant (P>0.05).The diagnostic coincidence rate of intracardiac electrophysiological examination was higher than that of color Doppler ultrasonography (P<0.05).The LAD,RVV and LAD in the intracardiac electrophysiological group were higher than those in the color Doppler ultrasound group (P<0.05).LVV in intracardiac electrophysiology group was lower than that in color Doppler ultrasound group (P<0.05). The indexes of heart valves in intracardiac electrophysiology group were higher than those in color Doppler ultrasound group,and the difference was statistically significant (P<0.05).Conclusion During the rheumatic heart disease atrial fibrillation with long RR interval examination,the intracardiac electrophysiological examination is satisfactory,and it is worthy of promotion and application in clinical practice.