实用医药杂志
實用醫藥雜誌
실용의약잡지
Practical Journal of Medicine & Pharmacy
2014年
7期
577-579
,共3页
室性心律失常%心率减速力%心脏猝死%预测
室性心律失常%心率減速力%心髒猝死%預測
실성심률실상%심솔감속력%심장졸사%예측
Ventricular tachycardia%Decceleration capacity of heart rate%Sudden cardiac death ( SCD )%Prediction
目的：对176例经Holter心电图监护所检出的室性心律失常患者行心率减速力（DC）检测，评价其对心脏猝死的临床预测价值。方法采用美国DMS公司的12导联同步描记Holter心电监护仪，对门诊及病房就诊的受检者进行24～72 h的Holter心电图监护，除常规心律失常及ST段监护指标外，同时检测窦性心率震荡（HRT）及心率变异（HRV）的心搏间RR间期标准差指标（SDNN）。将Holter心电监护直接记录出室性心动过速（VT）者列为观察组，共176例，男93例，女83例，年龄39～92岁，平均53岁；随机选取性别和年龄与观察组相仿的182例为对照组进行对比分析。结果以心率减速力＜4．5 ms为异常和＜2．5 ms为显著异常的标准，两组的心率减速力值异常率分别为50．6％（89/176）和4．4％（8/182），观察组明显高于对照组（χ2＝96．6，P＜0．05）；两组的心率减速力显著异常率分别为33．0％（58/176）和0％（0/182），两组间差异显著（χ2＝75．6，P＜0．05）；室性心动过速患者的心率减速力异常检出率明显高于HRT和HRV检测指标（χ2＝106．4，P＜0．05；χ2＝58．6，P＜0．05）。结论室性心动过速患者的心率减速力测定，有较高的异常检出率。
目的：對176例經Holter心電圖鑑護所檢齣的室性心律失常患者行心率減速力（DC）檢測，評價其對心髒猝死的臨床預測價值。方法採用美國DMS公司的12導聯同步描記Holter心電鑑護儀，對門診及病房就診的受檢者進行24～72 h的Holter心電圖鑑護，除常規心律失常及ST段鑑護指標外，同時檢測竇性心率震盪（HRT）及心率變異（HRV）的心搏間RR間期標準差指標（SDNN）。將Holter心電鑑護直接記錄齣室性心動過速（VT）者列為觀察組，共176例，男93例，女83例，年齡39～92歲，平均53歲；隨機選取性彆和年齡與觀察組相倣的182例為對照組進行對比分析。結果以心率減速力＜4．5 ms為異常和＜2．5 ms為顯著異常的標準，兩組的心率減速力值異常率分彆為50．6％（89/176）和4．4％（8/182），觀察組明顯高于對照組（χ2＝96．6，P＜0．05）；兩組的心率減速力顯著異常率分彆為33．0％（58/176）和0％（0/182），兩組間差異顯著（χ2＝75．6，P＜0．05）；室性心動過速患者的心率減速力異常檢齣率明顯高于HRT和HRV檢測指標（χ2＝106．4，P＜0．05；χ2＝58．6，P＜0．05）。結論室性心動過速患者的心率減速力測定，有較高的異常檢齣率。
목적：대176례경Holter심전도감호소검출적실성심률실상환자행심솔감속력（DC）검측，평개기대심장졸사적림상예측개치。방법채용미국DMS공사적12도련동보묘기Holter심전감호의，대문진급병방취진적수검자진행24～72 h적Holter심전도감호，제상규심률실상급ST단감호지표외，동시검측두성심솔진탕（HRT）급심솔변이（HRV）적심박간RR간기표준차지표（SDNN）。장Holter심전감호직접기록출실성심동과속（VT）자렬위관찰조，공176례，남93례，녀83례，년령39～92세，평균53세；수궤선취성별화년령여관찰조상방적182례위대조조진행대비분석。결과이심솔감속력＜4．5 ms위이상화＜2．5 ms위현저이상적표준，량조적심솔감속력치이상솔분별위50．6％（89/176）화4．4％（8/182），관찰조명현고우대조조（χ2＝96．6，P＜0．05）；량조적심솔감속력현저이상솔분별위33．0％（58/176）화0％（0/182），량조간차이현저（χ2＝75．6，P＜0．05）；실성심동과속환자적심솔감속력이상검출솔명현고우HRT화HRV검측지표（χ2＝106．4，P＜0．05；χ2＝58．6，P＜0．05）。결론실성심동과속환자적심솔감속력측정，유교고적이상검출솔。
Objective Through detecting the deceleration capacity of heart rate (DC) and other indicators, so as to evaluate the value of DC in clinical prediction of SCD. Methods The 5612 outpatients and inpatients underwent a 24-72 h Holter ECG,in addition to conventional arrhythmia and ST segment monitoring indicators, simultaneous detection of sinus heart rate turbulence(HRT) index of RR interval standard deviation and heart rate variability in cardiac room(SDNN). The Holter ECG was recorded directly from ventricular tachycardia(VT) as the observation group,among the 148 cases of patients with myocardial infarction,14 patients with dilated cardiomyopathy,9 cases of hypertensive heart disease,idiopathic ventricular tachycardia in 3 cases. Acoording to gender and age they were randomly selected,and divided into observation group (176 cases) and matched controls (182). Results The deceleration capacity of rate <4.5ms anomaly and <2.5ms for significant standard,the deceleration capacity of rate value anomaly rates in two groups were 50.6% (89/176) and 4.4% (8/182) respectively. There was a significant difference between the two groups (χ2=96.6,P<0.05);the abnormal detection rate for the deceleration capacity of rate was 33%(58/176) and 0%(0/182) in two groups respectively,the difference between the two groups was significant (χ2=75.6,P<0.05);the abnormal detedtion rate for VT patients was significantly higher than that of patients with HRT and HRV indexes (χ2=106.4,P<0.05;χ2=58.6,P<0.05). Conclusion DC of VT patient is more effective in detecting clinical prediction of HCD in patients.
