摘要
目的通过动态心电图判定功能性及器质性室性早搏。方法选取300例临床资料完整且诊断明确的室性早搏病例,观察其动态心电图(DCG)室性早搏的发生频度、规律与各项活动、精神因素及病种的关系,并与临床资料对照,寻找功能性及器质性室性早搏的鉴别方法。结果①器质性早搏多为均匀或无周期性早搏,功能性早搏多呈典型的周期规律;②早搏发生频度在200～500次/d之间时多为散在、均匀发生的器质性早搏(P<0.05);③心肌病、心肌炎、冠心病、先心病患者在运动后器质性早搏数目增多(P<0.05);④VE发生频度与运动之间无显著相关性(P>0.05)。结论依据DCG的表现并结合Lown氏和Schmroth氏的观点,强调早搏的周期性与非周期性特征是鉴别诊断的一个重要依据,可显著提高鉴别诊断的准确率。
Objective To find a specific identification method in order to realize the accurate clinical identification for organic and functional ventricular premature beat by dynamic electrocardiogram. Methods 300 ventricular premature beat cases were selected from outpatients and inpatients who were diagnosed and had complete clinical materials. To find a specific identification method by observing the relationship between frequency and rule of ventricular premature beat and diseases,mental factors or other activities and comparing them with clinical materials. Results ①Most of the organic ventricular premature beats were uniformity and without periodicity,most of the functional ventricular premature beats have typical periodicity law. ②Most of the ventricular premature beats were dispersed and uniform organic ventricular premature beats when they occurred between 200 ～ 500 everyday（P〈0. 05） . ③Cardiomyopathy,myocarditis,coronary heart disease,and congenital heart disease patients whose organic ventricular premature beats were raise postexercise（P〈0. 05） . ④There was no significant dependablity between produce frequency and exercise of ventricular premature beat（P〈0. 05） . The study finds that frequency of premature beat is between 200 to 300 per day and has no significant correlation with organic heart disease（P〉0. 05） . However,the periodicity of premature beats is significantly correlated with healthy heart（P〈0. 05） . The periodicity of most premature beats is affected with nervous and mental factors and has strong regularity,but some patients（21%） have nothing to do with nervous and mental factors. But it does not rule out the existence of intracardiac structural defects in developmental（Non-pathological） . Both DCG manifestations are also consistent with their pathogenesis. Conclusion According to the DCG manifestation and combine with the view of Lown and Schmroth,emphasizing that the characteristics of periodicity or non-periodicity of premature beats are basic to identify and diagnose can greatly improved the diagnosis accuracy.
出处
《中国现代药物应用》
2010年第14期29-31,共3页
Chinese Journal of Modern Drug Application
关键词
室性早搏
动态心电图
神经-精神因素
周期性
Ventricular premature beat
Dynamic electrocardiogram
Nervous and mental factors
Periodicity
