动态心电图检查在川崎病合并冠状动脉损害诊断中的临床应用价值

摘要

目的：探讨动态心电图检查在川崎病合并冠状动脉损害诊断中的临床应用价值。方法选择2012年1月至2014年8月浙江萧山医院收治的160例川崎病患者作为研究对象，其中80例川崎病未合并冠状动脉损害患者作为对照组，80例川崎病合并冠状动脉损害患者作为观察组。将观察组80例患者按照数字列表法随机平均分为动态心电图组与常规心电图组，各40例，所有研究对象均采用动态心电图与常规心电图进行检查，比较观察组与对照组动态心电图检测结果，以及观察组中动态心电图组与常规心电图组的检测结果。结果①观察组的患者中房室传导阻滞、平均心率升高发生率及异常总数均明显高于对照组，比较差异均具有统计学意义（χ2值分别为5．0171、8．3502、9．6274，均P＜0．05）；②动态心电图组的患者中房室传导阻滞所占的比例是20．00％，明显高于常规心电图组的2．50％，两组比较差异具有统计学意义（χ2＝4．1530，P＜0．05）；动态心电图组的患者中持续性心动过速所占的比例是27．50％，明显高于常规心电图组的0．00％，两组比较差异具有统计学意义（χ2＝8．8657，P＜0．05）；动态心电图组的患者中出现异常所占的比例是52．50％，明显高于常规心电图组的10．00％，两组比较差异具有统计学意义（χ2＝10．0253，P＜0．05）。结论动态心电图检查在川崎病合并心脏损害患者的诊断中明显优于常规心电图，可将动态心电图作为川崎病的常规检测手段，值得临床推广。%Objective To explore the clinical application value of dynamic electrocardiogram (ECG) in diagnosis of Kawasaki disease ( KD) combined with coronary artery lesions .Methods Totally 160 cases of KD treated in Zhejiang Xiaoshan Hospital during January 2012 to August 2014 were selected as research subjects , including 80 cases without coronary artery lesions in control group and 80 cases combined with coronary artery lesions in observation group .In the observation group 80 cases were randomly divided into dynamic ECG group and routine ECG group with 40 cases in each group according to number table methods .All patients were given dynamic ECG and routine ECG examination .The dynamic ECG detection results were compared between the observation group and the control group as well as the dynamic ECG group and routine ECG group in the observation group .Results The incidence rate of atrioventricular block , average heart increasing and total abnormal frequency in the observation group were significantly higher than those in the control group , and the differences were statistically significant (χ2 value was 5.0171, 8.3502 and 9.6274,respectively, all P <0.05).The proportion of atrioventricular block in the dynamic ECG group was 20.00%, which was significantly higher than 2.50%of the conventional ECG group with statistical significance (χ2 =4.1530,P<0.05).The proportion of patients with sustained tachycardia in the dynamic ECG group was 27.50%, and it was significantly higher than 0.00%of the conventional ECG group with significant difference (χ2 =8.8657,P<0.05). In the dynamic ECG group proportion of cases with abnormal results was 52.50%, and it was obviously higher than 10.00% in the conventional ECG group (χ2 =10.0253,P<0.05).Conclusion Dynamic ECG is obviously superior to conventional ECG in diagnostic of KD combined with coronary artery lesions , so it can be used as a routine detection means of KD , which is worthy of clinical promotion .