李君

[关键词] 诊断;心肌缺血;心律失常;动态心电图;冠心病

[中图分类号] R445          [文献标识码] A          [文章编号] 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

冠心病主要指冠狀动脉发生粥样硬化，从而导致管腔狭窄或堵塞，出现心肌缺血、缺氧，甚至坏死，最终发展成心脏疾病。当冠状动脉发生狭窄后，由于无法为心脏供应足够的血液，特别在剧烈运动时，血氧含量供应则更少[1]。最初血流量降低可能不会引发任何冠心病表现，但伴随冠状动脉内斑块的不断积聚，导致冠状动脉管腔直径逐渐减小，最终出现冠心病相关体征及临床表现。在疾病早期，由于患者无显著临床表现，因此极易出现漏诊或误诊等情况，不利于其治疗措施的及时开展，阻碍疾病康复[2]。常规心电图主要是通过使用心电图机经体表对心脏每一个心动周期所形成的电活动进行图形变化记录的一种检测技术。心电图在心脏疾病检查中较常使用，但是随着其在冠心病检查中的应用和推广，发现常规心电图在检测冠心病方面漏诊率较高，一定程度上降低诊断准确性，同时也给疾病治疗带来不利影响[3]。因此，探寻准确、有效的检测方式对提升心脏疾病诊断水平具有积极意义。有研究指出[4]，使用动态心电图进行检测可提升心肌缺血及心律失常检出率。但目前临床对这一说法尚未形成统一结论，并且对动态心电图与常规心电图在心肌缺血及心律失常检出率方面差异研究较少。因此，本研究对200例冠心病患者分别采用动态心电图和常规心电图检测，现报道如下。……