CAJ | 학술논문

目的：探讨长 RP 心动过速的动态心电图表现及其鉴别诊断依据。方法采用12通道动态心电图记录仪对35例长 RP 心动过速患者进行监测，对心动过速发作时的诱发及终止状态、持续时间、频率，P 波极性及临床特点等方面进行对比分析。结果持续性房室折返性心动过速（PAVRT）、房性心动过速（AT）及快-慢型房室结折返性心动过速（F-S-AVNRT）三组患者中，心动过速发生时 P 波于Ⅱ、Ⅲ、aVF 导联倒置，aVR 导联直立，RP 间期均＞PR 间期。6例 PAVRT 发作时均呈无休止状态，心动过速发作占24 h 总心跳的32．8％～50．0％，由室早诱发，发作时频率110～160次／min。15例房速均由房早诱发，发作阵数在1～186阵，发作时频率107～150次／min；两例 F-S-AVNRT 由房早伴 PR 间期延长所诱发，发作时频率127～182次／min。12例房扑伴2∶1房室传导由房早诱发，发作时心室率120～165次／min，符合 Bix 定律时心室率150次／min。结论动态心电图监测对长 RP 心动过速发作时的诱发及终止状态、持续时间、频率等有鉴别诊断意义，有助于诊断长 RP 心动过速。
목적：탐토장 RP 심동과속적동태심전도표현급기감별진단의거。방법채용12통도동태심전도기록의대35례장 RP 심동과속환자진행감측，대심동과속발작시적유발급종지상태、지속시간、빈솔，P 파겁성급림상특점등방면진행대비분석。결과지속성방실절반성심동과속（PAVRT）、방성심동과속（AT）급쾌-만형방실결절반성심동과속（F-S-AVNRT）삼조환자중，심동과속발생시 P 파우Ⅱ、Ⅲ、aVF 도련도치，aVR 도련직립，RP 간기균＞PR 간기。6례 PAVRT 발작시균정무휴지상태，심동과속발작점24 h 총심도적32．8％～50．0％，유실조유발，발작시빈솔110～160차／min。15례방속균유방조유발，발작진수재1～186진，발작시빈솔107～150차／min；량례 F-S-AVNRT 유방조반 PR 간기연장소유발，발작시빈솔127～182차／min。12례방복반2∶1방실전도유방조유발，발작시심실솔120～165차／min，부합 Bix 정률시심실솔150차／min。결론동태심전도감측대장 RP 심동과속발작시적유발급종지상태、지속시간、빈솔등유감별진단의의，유조우진단장 RP 심동과속。
Objective To study the manifestations of long RP tachycardia on ambulatory electro-cardiography(AECG)and its differential diagnostic basis.Methods By 12-channel AECG recorder, 35 patients with long RP tachycardia were monitored.At the attack of tachycardia,we made compara-tive analysis on its states of induction and termination,duration,frequency,P-wave polarity,clinical characteristics,etc.Results The enrolled 35 patients were divided into 3 groups:separately with persistent atrioventricular reentrant tachycardia(PAVRT),atrial tachycardia(AT),and fast-slow atri-oventricular nodal reentrant tachycardia(F-S-AVNRT).Among the 3 groups,P waves were inverted inⅡ,Ⅲ and aVF leads,aVR leads were upright,and RP intervals were all longer than PR intervals, at the onset of tachycardia.The attack of 6 cases of PAVRT was endless,tachycardia accounting for 32.8%—50.0% in the total heartbeats during 24 hours,with an attacking frequency ranging from 110 times/min to 160 times/min,which was induced by premature ventricular beats.AT was induced by atrial premature beats in 15 cases,with the number of onset episodes ranging from 1 to 186,and onset frequency 107—150 times/min.F-S-AVNRT in 2 cases was induced by atrial premature beats accom-panied with prolonged PR intervals,with an attack frequency ranging from 127 times/min to 182 times /min.Atrial flutter complicating 2 ∶1 atrioventricular conduction in 12 cases was induced by at-rial premature beats;Its onset ventricular rate ranged from 120 times/min to 165 times/min,and the ventricular rate reached 150 times/min when the conditions of the Bix law was met.Conclusion AECG monitoring plays a significant role in identifying the states of induction and termination,dura-tion,and frequency during the onset of long RP tachycardia.It helps to diagnose the disease.