运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值

摘要

Objective:To explore diagnostic value of exercise ECG and dynamic ECG (DCG)for organic heart disease (OHD)ventricular premature beat (VPB).Methods:A total of 135 VPB patients were selected from our hospital.Ac-cording to examination outcome,they were divided into OHD group (n=75)and non-OHD group (n=60).Results of ex-ercise ECG and DCG were compared between two groups.Results:Compared with non-OHD group,there were significant reductions in percentages of Lown grade Ⅰ and Ⅱ,and significant rise in percentages of Lown grade Ⅲ,IV-A and IV-B in OHD group,P <0.05 or <0.01. DCG indicated that compared with non-OHD group,there was significant reduction in percentage of type B (90.0% vs.14.67%),and significant rise in percentages of type A (1.67% vs.49.33%)and D (0% vs.34.67%)in OHD group,P =0.001 all;exercise ECG indicated that compared with non-OHD group,there was significant reduction in percentage of type E (61.67% vs.14.67%),and significant rise in percentages of type F (38.33%vs.85.33%)and ischemic ST segment change (0% vs.40.0%)in OHD group,P =0.001 all.Compared with non-OHD group,there were significant rise in incidence rates of atrial premature beat,paroxysmal supraventricular tachycardia,atrial flutter in OHD group,P <0.05 or <0.01.Sensitivity,specificity,positive and negative predictive value and accuracy of exercise ECG and DCG were higher both,and there were no significant difference between two groups (P >0.05 all). Conclusion:Diagnostic value of exercise ECG and DCG are significant for organic heart disease ventricular premature beat, but it is no significant difference between two methods,which is worth extending.%目的:探讨运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值.方法:选择我院室性早搏患者135例,根据检查结果分为器质性心脏病组(75例)与非器质性心脏病组(60例).比较两组运动心电图与动态心电图结果.结果:与非器质性心脏病组比较,器质性心脏病组LownⅠ、Ⅱ级所占比例明显降低,LownⅢ、Ⅳ-A、Ⅳ-B级比例显著升高(P<0.05或<0.01).动态心电图显示,与非器质性心脏病组比较,器质性心脏病组B型(90.0%比14.67%)所占比例明显降低,A(1.67%比49.33%)、D型(0%比34.67%)所占比例明显升高(P均=0.001);运动心电图显示,与非器质性心脏病组比较,器质性心脏病组E型(61.67%比14.67%)所占比例明显降低,F型(38.33%比85.33%)、缺血型ST段改变(0%比40.0%)所占比例明显升高(P均=0.001).器质性心脏病组合并房性早搏、阵发性室上性心动过速、心房扑动发生率明显高于非器质性心脏病组(P<0.05或<0.01).运动心电图和动态心电图诊断器质性心脏病室性早搏的敏感性,特异性,阳性预测值,阴性预测值与准确度均较高,但二者无统计学差异(P均>0.05).结论:运动心电图和动态心电图对器质性心脏病室性早搏的诊断价值显著,二者无显著差异,值得临床推广.