動(dòng)態(tài)心電圖在心律失常及心肌缺血中的診斷價(jià)值應(yīng)用

李君

[關(guān)鍵詞] 診斷;心肌缺血;心律失常;動(dòng)態(tài)心電圖;冠心病

[中圖分類號(hào)] R445? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1673-9701（2021）19-0030-04

Application of dynamic electrocardiogram in diagnosis of arrhythmia and myocardial ischemia

LI Jun

Department of Electrocardiography， Xiamen Hospital of Traditional Chinese Medicine， Xiamen? ?361000， China

[Abstract] Objective To analyze the diagnostic effect of dynamic electrocardiogram on myocardial ischemia and arrhythmia. Methods A total of 200 patients who were treated for coronary heart disease in our hospital from July 2018 and June 2020 were selected as the study samples. After admission， all patients underwent routine ECG and Holter examinations. The detection rates of myocardial ischemia， arrhythmia， and different types of arrhythmia between the two investigation methods were compared. Results The detection rates of myocardial ischemia by dynamic electrocardiogram and conventional ECG were 81.50% and 47.50%（P<0.05）. The detection rates of arrhythmia by dynamic electrocardiogram and conventional ECG were 87.50% and 56.50%（P<0.05）. The detection rates of atrioventricular block， ventricular premature beats， Single ventricular premature beat， premature ventricular beats， Single atrial premature beats，atrial premature beats， dual triptych， atrial premature beats， and paired atrial premature beats by dynamic ECG detection were higher than those of conventional electrocardiogram（P<0.05）. Conclusion The dynamic electrocardiogram in myocardial ischemia and arrhythmia can improve the accuracy of detection， and can also be used for the diagnosis of different arrhythmia types， which provides a basis for clinically reasonable treatment plans. And it is beneficial to the early treatment of the disease and plays a specific clinical application effect.

[Key words] Diagnosis; Myocardial ischemia; Arrhythmia; Dynamic electrocardiogram; Coronary heart disease

冠心病主要指冠狀動(dòng)脈發(fā)生粥樣硬化，從而導(dǎo)致管腔狹窄或堵塞，出現(xiàn)心肌缺血、缺氧，甚至壞死，最終發(fā)展成心臟疾病。當(dāng)冠狀動(dòng)脈發(fā)生狹窄后，由于無法為心臟供應(yīng)足夠的血液，特別在劇烈運(yùn)動(dòng)時(shí)，血氧含量供應(yīng)則更少[1]。最初血流量降低可能不會(huì)引發(fā)任何冠心病表現(xiàn)，但伴隨冠狀動(dòng)脈內(nèi)斑塊的不斷積聚，導(dǎo)致冠狀動(dòng)脈管腔直徑逐漸減小，最終出現(xiàn)冠心病相關(guān)體征及臨床表現(xiàn)。在疾病早期，由于患者無顯著臨床表現(xiàn)，因此極易出現(xiàn)漏診或誤診等情況，不利于其治療措施的及時(shí)開展，阻礙疾病康復(fù)[2]。常規(guī)心電圖主要是通過使用心電圖機(jī)經(jīng)體表對(duì)心臟每一個(gè)心動(dòng)周期所形成的電活動(dòng)進(jìn)行圖形變化記錄的一種檢測(cè)技術(shù)。心電圖在心臟疾病檢查中較常使用，但是隨著其在冠心病檢查中的應(yīng)用和推廣，發(fā)現(xiàn)常規(guī)心電圖在檢測(cè)冠心病方面漏診率較高，一定程度上降低診斷準(zhǔn)確性，同時(shí)也給疾病治療帶來不利影響[3]。因此，探尋準(zhǔn)確、有效的檢測(cè)方式對(duì)提升心臟疾病診斷水平具有積極意義。有研究指出[4]，使用動(dòng)態(tài)心電圖進(jìn)行檢測(cè)可提升心肌缺血及心律失常檢出率。但目前臨床對(duì)這一說法尚未形成統(tǒng)一結(jié)論，并且對(duì)動(dòng)態(tài)心電圖與常規(guī)心電圖在心肌缺血及心律失常檢出率方面差異研究較少。因此，本研究對(duì)200例冠心病患者分別采用動(dòng)態(tài)心電圖和常規(guī)心電圖檢測(cè)，現(xiàn)報(bào)道如下。