早产儿动态心电图的临床研究

Clinical study of dynamic electrocardiogram in preterm infants

目的 探讨早产儿动态心电图(DCG)特点。方法 应用Compas XM Holter动态心电图系统检测90例早产儿DCG。根据胎龄不同,将早产儿分为A、B、C三组,三组胎龄分别为～31、～34、～37周,以21例足月儿的DCG作为对照组。结果 早产儿心肌缺血的发生率A、B、C组分别为69％、59.5％、67.5％。室性早搏(VPC)的检出率A、B、C三组及对照组分别为95％、92％、80％、86％,早产儿VPC中以Lown分级L3级以上的较足月儿明显增多(P<0.05)。早产儿24h最快心率较足月儿慢(P<0.05)。结论 DCG对诊断早产儿无症状性心肌缺血具有重要临床意义,并能发现潜在高危心律失常。

Objective To evaluate the characteristics of dynamic electrocardiogram(DCG) in the preterm infants. Methods Compas XM Holter system was used to detect DCG in 90 preterm infants and 21 term infants. The preterm infants were divided into A,B and C groups according to gestation age which were -31, -34 and -37 weeks respectively. Results The detectable rates of asymptomatic myocardial ischemia of A,B and C groups were 69% ,59.5% and 67.5% respectively. The detectable rates of ventricular premature contraction(VPC) in A,B,C and control groups were 95% , 92%, 80% and 86% respectively . VPC above L3 grade according to Lown's classification method in preterm infants increased significantly compared with control group (P<0.05). Maximum heart rales (MHR)of A,B,C and control groups were 181±12,183±12,188±15 and 200±11 beats/min respectively. There were significant differences for MHR among A,B,C groups and control group (P<0.05). Conclusion DCG monitoring in preterm infants is very important for the diagnosing asymptomatic myocardial ischemia and potential risk arrhythmia.