中老年心血管疾病患者323例24 h动态心电图分析

Clinical analysis of 24-hour dynamic electrocardiographic changes in 323 middle-aged and older adult patients with cardiovascular disease

目的分析中老年心血管疾病患者的24 h动态心电图变化,为临床针对性干预提供有效指导。方法回顾性分析山西省煤炭中心医院2019年4月至2021年4月收治的中老年心血管疾病患者323例的临床资料,其中年龄≥60岁的心血管疾病患者166例纳入观察组,40岁≤年龄<60岁的心血管疾病患者157例纳入对照组,比较两组24 h动态心电图变化。结果观察组房性心律失常、室性心律失常、窦性心律失常、复杂性室性心律失常、复杂性房性心律失常检出率分别为96.99%、88.55%、28.31%、39.76%、52.41%,均明显高于对照组的50.32%、50.96%、8.28%、9.55%、8.92%,差异均有统计学意义(χ^(2)=19.21、28.75、23.45、6.90、8.06,均P<0.001);观察组心肌缺血发作时间[(1.5±0.5)min]明显短于对照组[(2.5±0.5)min](t=23.09,P<0.001),且观察组心肌缺血发作时间多为0∶00~8∶00时。结论60岁以上的老年人更容易出现心血管疾病,且随着年龄的增长,心血管疾病发病风险越高,尤其是0∶00~8∶00时,应进行24 h动态心电图监测,帮助临床深入掌握患者实际情况,指导临床有效防治心肌缺血的发生。

Objective To analyze the 24-hour dynamic electrocardiographic changes in middle-aged and older adult patients with cardiovascular disease,providing effective guidance for clinical targeted intervention.Methods The clinical data of 232 middle-aged and older adult patients who received treatment in Shanxi Coal Central Hospital from April 2019 to April 2021 were retrospectively analyzed.Among these patients,166 patients with cardiovascular disease aged≥60 years were included in the observation group,and 157 patients with cardiovascular disease aged<60 years were included in the control group.The 24-hour dynamic electrocardiographic changes were compared between the two groups.Results The detection rates of atrial arrhythmias,ventricular arrhythmias,sinus arrhythmias,complex ventricular arrhythmias,and complex atrial arrhythmias in the observation group were 96.99%,88.55%,28.31%,39.76%,and 52.41%respectively,which were significantly higher than 50.32%,50.96%,8.28%,9.55%,8.92%in the control group(χ^(2)=19.21,28.75,23.45,6.90,8.06,all P<0.001).The time of myocardial ischemia attack in the observation group[(1.5±0.5)minutes]was significantly shorter than that in the control group[(2.5±0.5)minutes,t=23.09,P<0.001].The time of myocardial ischemia attack in the observation group was mostly from 0:00 a.m.to 8:00 a.m.Conclusion Patients aged≥60 years are more likely to develop cardiovascular disease.The risk of cardiovascular diseases increase with increasing age.In particular at 0:00 a.m.to 8:00 a.m.,24-hour dynamic electrocardiographic changes should be monitored to further understand the actual situation of patients and guide clinical effective prevention and treatment of myocardial ischemia.