老年冠心病患者心肌缺血和心律失常动态心电图在诊断中的价值

The Value of Dynamic Electrocardiogram in the Diagnosis of Myocardial Ischemia and Arrhythmia in Elderly Patients with Coronary Heart Disease

目的分析动态心电图在老年冠心病患者心肌缺血与心律失常动态诊断过程中的临床价值。方法该次研究选择该院2016年8月-2018年8月所收治的140例老年冠心病患者作为研究对象,先对所有的患者进行常规心电图检查,为了避免因不同时间段和治疗前后对于最终诊断结果的影响,在常规心电图检查之后需要使用动态心电记录仪对所有患者24 h内的心电变化情况进行信息处理和分析,以此为基础进行综合性诊断。之后对所有患者的生化指标数据进行检查对比,常规心电图对于心肌缺血的诊断标准以T波水平、ST水平作为参考依据,而动态心电图的心肌缺血判断标准以再次发作与前次ST段的前后间隔时间作为判定。心律失常的诊断标准则主要按照节律、起止特点与持续临床症状为判断依据,按照Lown法分级,判断动态心电图的价值。结果该次研究结果表明,在老年冠心病患者诊断结果数据方面,动态心电图在心房颤动、室性早搏、房性早搏、房室阻滞、左束支阻滞与右束支阻滞几项指标的占比分别为5.0%,23.6%,39.3%,9.3%,11.4%,10.0%,均要优于常规心电图的1.4%,14.3%,19.3%,3.6%,6.4%,5.7%,说明动态心电图可以更好地提供临床诊断依据。两种诊断方式数据差异有统计学意义(X^2=5.225、3.689、8.058、4.606、4.798、3.227,P<0.05)。结论动态心电图可以为临床诊断提供更加全面可靠的数据,对于老年冠心病患者的疾病诊断和心肌缺血、心律失常等并发症的预防也具有显著的现实意义,可以有效反映出各种类型并发症地发作。

Objective To analyze the clinical value of dynamic electrocardiogram in the dynamic diagnosis of myocardial ischemia and arrhythmia in elderly patients with coronary heart disease.Methods In this study,140 elderly patients with coronary heart disease admitted to our hospital from August 2016 to August 2018 were selected as subjects.All patients were given routine electrocardiogram in order to avoid the end of time and before and after treatment.The impact of the diagnosis results,after the conventional ECG examination,the dynamic ECG recorder was needed to process and analyze the ECG changes in all patients within 24 hours,based on which a comprehensive diagnosis was made.After that,the biochemical data of all patients were examined and compared.The diagnostic criteria of conventional electrocardiogram for myocardial ishemia were based on T wave level and ST level,while the standard of myocardial ischemia of dynamicelectrocardiogram was re-existed with the previous ST segment,and the interval time was used as a decision.The diagnostic criteria for arrhythmia were based on the rhythm,the characteristics of starting and ending,and the persistence of clinical symptoms.The value of the dynamic electrocardiogram was judged according to the classification of the Lown method.Results The results of this study showed that in the diagnosis of elderly patients with coronary heart disease,dynamic electrocardiogram in atrial fibrillation,ventricular premature beats,atrial premature beats,atrioventricular block,left bundle branch block and right bundle branch block several indicators proportions were 5%,23.6%,39.3%,9.3%,11.4%,and 10.0%,respectively,which were better than 1.4%,14.3%,19.3%,3.6%,6.4%,and 5.7% of conventional ECG.An electrocardiogram can better provide a basis for clinical diagnosis.The data of the two diagnostic methods were significantly different(χ^2=5.225,3.689,8.058,4.606,4.798,3.227,P<0.05).Conclusion Dynamic electrocardiogram can provide more comprehensive and reliable data for clinical diagnosis.It also has significant practical significance for the diagnosis of diseases and myocardial ischemia and arrhythmia in elderly patients with coronary heart disease,which can effectively reflect various types of concurrency and the onset of the disease.