Value of dynamic electrocardiogram in diagnosing myocardial ischemia and arrhythmia of patients with coronary heart disease
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摘要:目的
探讨动态心电图诊断冠心病(CHD)患者心肌缺血与心律失常的价值。
方法选取2018年1月-2020年6月收治的CHD患者212例, 均行动态心电图和常规心电图检测。比较2种方法检测心肌缺血、心律失常的情况以及患者满意度。
结果动态心电图检测心肌缺血的阳性率高于常规心电图检测, 对心肌缺血有症状的检出率高于常规心电图检测, 差异均有统计学意义(P < 0.05)。在心律失常检出类型中, 动态心电图对房性逸搏二、三联律, 房性早搏二、三联律, 左束支阻滞, 右束支阻滞以及房室传导阻滞的检出率高于常规心电图, 差异有统计学意义(P < 0.05)。患者对动态心电图检测的总满意度为96.22%, 高于常规心电图检测的75.94%, 差异有统计学意义(P < 0.05)。
结论动态心电图可以有效提升CHD患者心肌缺血与心律失常的诊断效果, 且患者满意度较高, 值得临床应用。
Abstract:ObjectiveTo investigate the value of dynamic electrocardiogram in diagnosing myocardial ischemia and arrhythmia of patients with coronary heart disease (CHD).
MethodsA total of 212 patients with CHD from January 2018 to June 2020 were selected and conducted both dynamic electrocardiogram and routine electrocardiogram.The detection conditions of myocardial ischemia and arrhythmia as well as patient's satisfaction degree were compared between the two methods.
ResultsThe positive rate of myocardial ischemia detected by dynamic electrocardiogram was significantly higher than that by routine electrocardiogram, and the detection rates of symptomatic and asymptomatic myocardial ischemia were significantly higher than that detected by routine electrocardiogram (P < 0.05).Among the detection types of arrhythmias, the detection rates of binary and triple rhythm of atrial escape beats and atrial premature beats, left and right bundle branch block and atrioventricular block by dynamic electrocardiogram were significantly higher than those by routine electrocardiogram (P < 0.05).The patient's total satisfaction degree to dynamic electrocardiogram was 96.22%, which was significantly higher than 75.94% of routine electrocardiogram (P < 0.05).
ConclusionDynamic electrocardiogram can effectively improve the diagnostic effect of myocardial ischemia and arrhythmia in patients with CHD, and the patient's satisfaction degree is high, which is worthy of clinical application.
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表 1 2种方法对心肌缺血的检出情况比较(n=212)[n(%)]
检测方法 阳性 阴性 有症状 无症状 动态心电图 187(88.21)* 25(11.79)* 81(38.21)* 131(61.79)* 常规心电图 144(67.92) 68(32.08) 42(19.81) 170(80.19) 与常规心电图比较, *P < 0.05。 
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表 2 2种方法对心律失常的检出情况比较(n=212)[n(%)]
心律失常类型 动态心电图 常规心电图 房性逸搏早发 78(36.79) 64(30.19) 房性逸搏二、三联律 127(59.91)* 85(40.09) 房性逸搏成对 68(32.08) 51(24.06) 房性早搏早发 68(32.08) 64(30.19) 房性早搏二、三联律 98(46.22)* 55(25.94) 房性早搏成对 68(32.08) 42(19.81) 左束支阻滞 89(41.98)* 42(19.81) 右束支阻滞 81(38.21)* 42(19.81) 房室传导阻滞 85(40.09)* 42(19.81) 房颤 81(38.21) 64(30.19) 房扑 64(30.19) 42(19.81) 房性逸搏 55(25.94) 42(19.81) 与常规心电图比较, *P < 0.05。
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表 3 患者对2种检测方法的满意度比较(n=212)[n(%)]
检测方法 很满意 满意 不满意 总满意 动态心电图 191(90.09) 13(6.13) 8(3.78) 204(96.22)* 常规心电图 148(69.81) 13(6.13) 51(24.06) 161(75.94) 与常规心电图比较, *P < 0.05。
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