频发室性早搏动态心电图分析(1)
摘要：目的 通过动态心电图对频发室性早搏进行分析，探讨器质性心脏病患者出现病理性室性早搏时发生恶性心律失常的预测价值。方法 选取我院57例频发室性早搏患者采用动态心电图监测，其中41例有器质性心脏病，16例无器质性心脏病。结果 57例患者中室早总数>4万次2例，3～4万次5例，2～3万次16例，1～2万次34例；白天相对多者20例，夜间相对多者13例，昼夜均衡者24例；Ⅱ级32例，Ⅲ级11例，Ⅳa 7例，Ⅳb 5例，Ⅴ级2例。心脏病组在室性心律失常的基础上伴有房性早搏19例，复杂性室上性心律失常8例，左前分支传导阻滞3例，室内双束支传导阻滞2例，7例患者伴有缺血性ST-T改变。结论 室性早搏严重程度主要取决于室性早搏产生的基本原因、全身情况、心功能状态、室早产生的性质以及室早以外的复杂心电图变化，及早发现心源性猝死潜在因素，有助于采取有力治疗措施。
关键词：室性早搏；动态心电图；心脏病
中图分类号：R541.7 文献标识码：A 文章编号：1006-1959(2017)26-0173-03
, 百拇医药
Abstract：Objective To investigate the predictive value of malignant ventricular arrhythmia in patients with organic heart disease by dynamic electrocardiogram(ECG)analysis of frequent ventricular premature beats.Methods 57 patients with frequent premature ventricular contractions in our hospital were monitored by dynamic electrocardiogram.Among them，41 had organic heart disease and 16 had no organic heart disease.Results In 57 patients，the total number of ventricular premature>40 thousand times in 2 cases，3～4 million times in 5 cases，2～3 million times in 16 cases，1～2 million times in 34 cases；There were 20 patients with relatively more daytime，13 patients with relatively more nighttime and 24 patients with daytime and nighttime balance.There were 32 cases of grade Ⅱ，11 cases of grade Ⅲ，7 cases of Ⅳa，5 cases of Ⅳb and 2 cases of class Ⅴ.On the basis of ventricular arrhythmia，the heart disease group was accompanied by 19 cases of atrial premature beats，8 cases of complex supraventricular arrhythmias， 3 cases of left anterior branch block，2 cases of indoor double bundle branch block，7 cases Accompanied by ischemic ST-T changes.Conclusion The severity of ventricular premature beats mainly depends on the basic causes of ventricular premature beats，the general condition，cardiac function，the nature of ventricular premature beats，and the complex ECG changes outside the chamber.Early detection of the potential factors of sudden cardiac death can help to take effective treatment measures.
, 百拇医药
Key words：Ventricular premature beat；Dynamic electrocardiogram；Heart disease
室性早搏(ventricular premature beat，VPB)或室性期前收缩简称室早，是临床上常见的一种自主性异位心律失常，其发生人群广泛，包括健康人群和各种心脏病患者，也是诱发室性心动过速和心室颤动的重要原因之一。频繁的室性早搏也可诱发心绞痛的发生。常规心电图是诊断心律失常的基本方法，因只能记录有限的一段时间，不能排除其它时间出现心律失常。本文对57例频发室性早搏患者采用动态心电图(DCG)进行监测，以探讨病理性室早的特点及临床意义。
1 资料与方法
1.1一般资料
选择我院2014年1月～2016年12月动态心电图检查频发室早的患者57例，其中男35例，女22例；年龄25～81岁，平均年龄(53±1)岁。多数受检者有不同程度的胸闷、心前区不适、头晕、乏力，自诉有心脏漏跳感，少数患者无自觉症状。根据临床症状、体检、实验室、X线胸片、心脏超声以及無创性心功能检查等结果，将受检者分为心脏病组和非心脏病组。心脏病组41例，其中冠心病22例(含陈旧性心肌梗塞1例)，心肌炎9例，扩张型心肌病2例，预激综合征1例，高血压性心脏病4例，风湿性心脏病2例，心力衰竭1例。非心脏病组16例。所有受检者检查前均未接受洋地黄或抗心律失常等药物治疗，无电解质紊乱。, 百拇医药(孙玉芬)
关键词：室性早搏；动态心电图；心脏病
中图分类号：R541.7 文献标识码：A 文章编号：1006-1959(2017)26-0173-03
, 百拇医药
Abstract：Objective To investigate the predictive value of malignant ventricular arrhythmia in patients with organic heart disease by dynamic electrocardiogram(ECG)analysis of frequent ventricular premature beats.Methods 57 patients with frequent premature ventricular contractions in our hospital were monitored by dynamic electrocardiogram.Among them，41 had organic heart disease and 16 had no organic heart disease.Results In 57 patients，the total number of ventricular premature>40 thousand times in 2 cases，3～4 million times in 5 cases，2～3 million times in 16 cases，1～2 million times in 34 cases；There were 20 patients with relatively more daytime，13 patients with relatively more nighttime and 24 patients with daytime and nighttime balance.There were 32 cases of grade Ⅱ，11 cases of grade Ⅲ，7 cases of Ⅳa，5 cases of Ⅳb and 2 cases of class Ⅴ.On the basis of ventricular arrhythmia，the heart disease group was accompanied by 19 cases of atrial premature beats，8 cases of complex supraventricular arrhythmias， 3 cases of left anterior branch block，2 cases of indoor double bundle branch block，7 cases Accompanied by ischemic ST-T changes.Conclusion The severity of ventricular premature beats mainly depends on the basic causes of ventricular premature beats，the general condition，cardiac function，the nature of ventricular premature beats，and the complex ECG changes outside the chamber.Early detection of the potential factors of sudden cardiac death can help to take effective treatment measures.
, 百拇医药
Key words：Ventricular premature beat；Dynamic electrocardiogram；Heart disease
室性早搏(ventricular premature beat，VPB)或室性期前收缩简称室早，是临床上常见的一种自主性异位心律失常，其发生人群广泛，包括健康人群和各种心脏病患者，也是诱发室性心动过速和心室颤动的重要原因之一。频繁的室性早搏也可诱发心绞痛的发生。常规心电图是诊断心律失常的基本方法，因只能记录有限的一段时间，不能排除其它时间出现心律失常。本文对57例频发室性早搏患者采用动态心电图(DCG)进行监测，以探讨病理性室早的特点及临床意义。
1 资料与方法
1.1一般资料
选择我院2014年1月～2016年12月动态心电图检查频发室早的患者57例，其中男35例，女22例；年龄25～81岁，平均年龄(53±1)岁。多数受检者有不同程度的胸闷、心前区不适、头晕、乏力，自诉有心脏漏跳感，少数患者无自觉症状。根据临床症状、体检、实验室、X线胸片、心脏超声以及無创性心功能检查等结果，将受检者分为心脏病组和非心脏病组。心脏病组41例，其中冠心病22例(含陈旧性心肌梗塞1例)，心肌炎9例，扩张型心肌病2例，预激综合征1例，高血压性心脏病4例，风湿性心脏病2例，心力衰竭1例。非心脏病组16例。所有受检者检查前均未接受洋地黄或抗心律失常等药物治疗，无电解质紊乱。, 百拇医药(孙玉芬)
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