老年心源性晕厥动态心电图的诊断价值探讨

Discussion on the Diagnostic Value of Cardiogenic Syncope Dynamic Electrocardiogram in the Elderly

目的分析动态心电图诊断老年心源性晕厥的临床应用价值。方法方便选取2017年1月—2020年1月该院收治疑似老年心源性晕厥患者76例进行观察分析,分别进行常规心电图与动态心电图诊断,对比两种诊断方法灵敏度、特异性、准确性差异,对比分析不同群体心律失常情况。结果经诊断,老年心源性晕厥疑似患者确诊阳性60例,占比78.95%,确诊阴性16例,占比21.05%。经常规心电图诊断检出阳性患者50例,阴性患者26例,经动态心电图诊断检出阳性患者59例,阴性患者17例。经计算,动态心电图诊断准确性、灵敏度、特异性均明显高于常规心电图,差异有统计学意义(χ^(2)=19.571、26.772、20.955,P<0.05)。此外,心源性晕厥阳性患者出现窦性过缓、窦性停搏概率与阴性患者,差异无统计学意义(P>0.05),阳性阵发性心动过速、单纯性房室期前收缩患者概率明显高于阴性患者,差异有统计学意义(P<0.05)。结论通过动态心电图能够准确显现患者心脏情况,为临床提供可靠数据支持,值得推广应用。

Objective To analyze the clinical application value of dynamic electrocardiogram in the diagnosis of cardiogenic syncope in the elderly.Methods Seventy-six suspected elderly patients with cardiogenic syncope admitted to the hospital from January 2017 to January 2020 were convenience selected for observation and analysis.Conventional electrocardiogram(ECG)and dynamic electrocardiogram(DGS)diagnosis were performed respectively.Differences in sensitivity,specificity and accuracy of the two diagnostic methods were compared to analyze arrhythmia in different populations.Results After diagnosis,60 cases of suspected elderly cardiogenic syncope were diagnosed as positive,accounting for 78.95%,and 16 cases were diagnosed as negative,accounting for 21.05%.According to routine electrocardiogram diagnosis,50 cases were positive patients,26 cases were negative patients,59 cases of positive patients were detected by Holter,and 17 cases were negative patients.After calculation,the diagnostic accuracy,sensitivity and specificity of Holter electrocardiogram were significantly higher than those of conventional electrocardiogram,and the difference was statistically significant(χ^(2)=19.571,26.772,20.955,P<0.05).In addition,there was no statistically significant difference in the probability of sinus bradycardia and sinus arrest in patients with positive cardiogenic syncope and negative patients(P>0.05),the probability of patients with positive paroxysmal tachycardia and simple atrioventricular premature contraction was significantly higher than that of negative patients,and the difference was statistically significant(P<0.05).Conclusion The dynamic electrocardiogram(DCG)can accurately show the patient's heart condition and provide reliable data support for clinical practice,which is worthy of popularization and application.