立位心电图ST-T变化对器质性心脏病伴β-受体过敏综合征的诊断意义

Diagnostic significance of ECG ST-T changes in standing position to organic heart diseases with Beta receptor anaphylaxis syndrome

目的 探讨立位心电图 ST- T变化在器质性心脏病伴 β-受体过敏综合征诊断中的意义。方法 对 35例健康者 (组 ) ,4 2例 β-受体过敏综合征 (组 ) ,34例器质性心脏病 (组 ) ,36例器质性心脏病伴 β-受体过敏综合征 (组 )患者的卧、立位心电图 ST- T波及心率进行对比研究 ,并观察心得安试验对其影响。结果 组 与组 ,组 与组 卧、立位心率增快程度不同 ,后者均分别大于前者 (P<0 .0 1) ;组 患者的卧位心电图 ST- T正常 ,转为立位时ST- T发生异常改变 (71.4 2 % ) ,或卧位心电图 ST- T异常 ,转为立位时 ST- T异常的程度与范围加重 (2 8.5 7% ) ;组 心电图 ST- T正常及组 原有 ST- T改变者分别在卧、立位对比时无明显变化 ;组 者立位时原异常 ST- T变化的程度与范围加重 (10 0 % ) ;卧位心得安试验使组 患者的心电图 ST- T改变完全恢复正常 ,组 无改善 ,组 轻度改善。结论 立位心电图 ST- T动态变化、心率增快程度及心得安试验 ,对器质性心脏病伴 β-受体过敏综合征的诊断。

Objective To study the value of ECG ST-T changes in standing position's diagnosis to organic heart di- seases with beta receptor anaphylaxis syndrome. Methods ECG ST-T and heart rate in supine and standing position of 35 normal controls(GroupⅠ), 42 beta receptor anaphylaxis syndrome(GroupⅡ),34 organic heart diseases(GroupⅢ) and 36 organic heart diseases with beta receptor anaphylaxis syndrome(GroupⅣ) patients were compared, and the effects of propranolol test were observed. Results The degree in increasing heart rate of supine and standing position was different among GroupⅠ and GroupⅡ,GroupⅢ and GroupⅣ. The latter was higher than the former(P<0.01). When GroupⅡ patient ECG ST-T normal in supine position change to standing position, ST-T was changed unnormal(71.42%). The unnormal degree and range of ST-T were higher(28.5%) when ECG in supine position turns into standing position unexpectedly. The ECG ST-T of GroupⅠ was normal and GroupⅢ was no obvious changes when changing supine position into standing position. The degree and range of the changes of ECG ST-T in GroupⅣ were increased(100%). The propranolol test of supine position makes the changes of the ECG ST-T in GroupⅡ patients regain normal completely. GroupⅢ were no improvement and GroupⅣ was slight improvement. Conclusion The changes of ECG ST-T in standing position, the degree of heart rate in incresing and propranolol test have important significance for diagnosing and guiding treatment to organic heart diseases with beta receptor anaphylaxis syndrome.