RR-Lorenz散点图在多源性房性早搏和房性并行心律中的诊断价值

Diagnostic value of RR-Lorenz plot in frequent atrial premature beats and atrial parasystolic rhythm

目的探讨RR-Lorenz散点图在多源性房性早搏(frequent atrial premature beats,FAPB)和房性并行心律(atrial parasystolic rhythm,APSR)中的诊断价值。方法选取经动态心电图(dynamic electrocardiography,DCG)诊断的594例频发房性早搏病例作为研究对象,调取DCG资料,对594例DCG分别用传统分析方法和RR-Lorenz散点图分析方法进行回顾性分析,得出诊断结论。结果594例频发房早中,传统分析方法诊断APSR 53例,FAPB 78例;经RR-Lorenz散点图诊断APSR 70例,FAPB 45例,2种分析方法比较差异有统计学意义(χ^2=4.629,P=0.032;χ^2=4.939,P=0.026);与传统方法相比,RR-Lorenz散点图法诊断的早搏总数和未下传房早总数明显增多(t=9.263,t=5.28;P=0.018,P=0.022);对2种方法诊断的APSR和FAPB做进一步分析发现:传统分析法和RR-Lorenz散点图分析法在心室内差异传导、融合波、未下传房早的诊断中差异有统计学意义(P<0.05)。结论RRLorenz散点图对房性心律失常的诊断具有较高的应用价值,可快速识别FAPB和APSR。

Objective To explore the value of RR-Lorenz plot in the diagnosis of frequent atrial premature beats(FAPB)and atrial parasystolic rhythm(APSR).Methods The dynamic electrocardiography(DCG)of 594 patients with FAPB were retrospectively analyzed by using traditional and RR-Lorenz plot analysis method respectively.Results Fiftythree patients and 78 patients were diagnosed as APSR and FAPB respectively by using traditional analysis,while 70 patients and 45 patients were diagnosed as APSR and FAPB by using RR-Lorenz plot analysis method.There was a significantly difference between the traditional method and RR-Lorenz plot method(χ^2=4.629,P=0.032;χ^2=4.939,P=0.026).Compared to traditional analysis,the aggregate of premature beat and that of atrial premature beats failing to transfer examined by RR-Lorenz plot were increased significantly(t=9.263,t=5.28;P=0.018,P=0.022).A further analysis revealed that there was significant difference among the two analysis methods in intraventricular aberrant conduction,fusion wave and atrial premature failing beats to transfer(P<0.05).Conclusion RR-Lorenz plot is of great value to the diagnosis of atrial arrhythmia and could identify FAPB and APSR quickly.