儿童特发性室性早搏动态心电图特点与年龄因素的研究

Study on Characteristics and Age Factors of Holter Electrocardiogram of Idiopathic Ventricular Premature Beat in Children

目的:研究特发性室性早搏患儿动态心电图的特点和年龄因素的相关性。方法:纳入2021年1月~2023年11月医院收治的特发性室性早搏患儿为主要研究病例,共92例。根据来源部位不同,随机划分为46例的左室型组、46例的右室型组,两组均实施24h的动态心电图检测,针对两组动态心电图的相关指标展开分析与统计学比较。结果:左室型组的全程窦性R-R间期的标准差、相邻R-R间期差值标准差、全程相邻R-R间期差值均方根、相邻R-R间期差值在50ms以上的百分数和24h连续5min一段正常R-R间期的标准差平均数相较右室型组均明显更低,差异特征明显(P<0.01);与右室型组相比,左室型组表现出了明显的递减(P<0.01);两组患儿室性早搏的总数没有体现出显著性差异(P>0.05);特发性室性早搏患儿的来源、心率变异性时域分析指标和QRS时限与年龄因素均表现为正相关。结论:在特发性室性早搏患儿中应用动态心电图,能够根据心电图变化情况了解患儿的自主神经活动,判定室性早搏发生的情况,同时室性早搏的来源与年龄有一定相关性。

Objective:To study the correlation between characteristics of holter electrocardiogram and age factors in children with idiopathic premature ventricular beat.Methods:A total of 92 children with idiopathic ventricular premature beat admitted to the hospital from January 2021 to November 2023 were included as the main study cases.According to different source sites,46 cases of left ventricular type group and 46 cases of right ventricular type group were randomly divided into two groups.24h holter ECG detection was performed in both groups,and relevant indicators of holter ECG in the two groups were analyzed and statistically compared.Results:The standard deviation of the whole sinus R-R interval,the standard deviation of the difference between adjacent R-R intervals,the root mean square of the whole adjacent R-R interval difference,the percentage of the adjacent R-R interval difference above 50ms and the mean standard deviation of the normal R-R interval for 5 minutes at 24h in the left ventricular type group were significantly lower than those in the right ventricular type group.The difference was obvious(P<0.01).Compared with right ventricular type group,left ventricular type group showed a significant decrease(P<0.01).There was no significant difference in the total number of premature ventricular beats between the two groups(P>0.05).The origin,time domain analysis of heart rate variability and QRS duration were positively correlated with age in idiopathic premature ventricular beats.Conclusions:The application of holtocardiogram in children with idiopathic ventricular premature beat can understand the autonomic nerve activity and determine the occurrence of ventricular premature beat according to the changes of electrocardiogram.Meanwhile,the source of ventricular premature beat is related to age.