頻發(fā)室性早搏的臨床特征及其意義
發(fā)布時(shí)間:2018-05-06 00:14
本文選題:室性早搏 + 特征 ; 參考:《江蘇大學(xué)》2017年碩士論文
【摘要】:一、目的室性早搏(PVC)是臨床上最常見的心律失常,但目前國(guó)內(nèi)關(guān)于其流行及特征等研究尚少;本研究主要對(duì)江蘇大學(xué)附屬醫(yī)院心內(nèi)科頻發(fā)室性早搏患者的癥狀特點(diǎn)及心電圖特征進(jìn)行統(tǒng)計(jì)和分析。二、方法對(duì)2014年1月—2015年12月期間在江蘇大學(xué)附屬醫(yī)院心血管內(nèi)科就診患者行12導(dǎo)聯(lián)心電圖、24小時(shí)動(dòng)態(tài)心電圖監(jiān)測(cè);篩選出符合條件的頻發(fā)室性早搏患者,收集其心臟多普勒數(shù)據(jù)、一般臨床資料和癥狀特征,測(cè)量患者的氮末端-腦利鈉肽前體(NT-proBNP),分析頻發(fā)室早患者心功能減退的相關(guān)因素。三、結(jié)果1、本研究共篩選出患者91例,平均年齡48±19歲,癥狀持續(xù)時(shí)間45±16月,其中心悸66例,無癥狀23例,暈厥2例,氣短或頭暈或乏力共31例;24小時(shí)PVC平均數(shù)量為(19782.5±11289.8)次,PVC平均負(fù)荷(22.5±12.7)%。2、PVC負(fù)荷及PVC-QRS波時(shí)限與LVEDD、BNP、左室流出道起源呈正相關(guān),與LVEF呈負(fù)相關(guān);此外,PVC負(fù)荷與男性,PVC-QRS時(shí)限與年齡、癥狀持續(xù)時(shí)間、PVC負(fù)荷呈正相關(guān)。3、與LVEF≥50%組相比,LVEF50%組患者的PVC-QRS波時(shí)限、癥狀持續(xù)時(shí)間更長(zhǎng)及左室舒張末內(nèi)徑(LVEDD)、PVC負(fù)荷、PVC數(shù)量、左室流出道起源比例更大(P㩳0.05)。四、結(jié)論江蘇大學(xué)附屬醫(yī)院心血管內(nèi)科頻發(fā)室早患者的檢出率為1.6%,其中絕大多數(shù)患者以心悸為主要臨床癥狀,但也有少部分患者表現(xiàn)為暈厥等。PVC負(fù)荷及PVC-QRS波時(shí)限與LVEDD、BNP、左室流出道起源室早、LVEF存在相關(guān)性;且PVC-QRS波時(shí)限、左室流出道起源PVC、PVC癥狀持續(xù)時(shí)間及男性是LVEF降低的預(yù)測(cè)因素。另外,PVC-QRS波的時(shí)限、PVC癥狀持續(xù)時(shí)間、PVC起源部位對(duì)治療室早方法的選擇可能有一定的臨床價(jià)值。
[Abstract]:Objective: PVC (ventricular premature beat) is the most common arrhythmia in clinic, but there are few studies on its prevalence and characteristics in China. The characteristics of symptoms and electrocardiogram of patients with frequent ventricular premature beats in Department of Cardiology, affiliated Hospital of Jiangsu University were analyzed. Methods from January 2014 to December 2015, patients in the Department of Cardiovascular Medicine, affiliated Hospital of Jiangsu University, were monitored by 12-lead electrocardiogram (ECG) and 24-hour ambulatory electrocardiogram (ECG). The cardiac Doppler data, general clinical data and symptom characteristics were collected to measure the N-terminal-brain natriuretic peptide precursor NT-proBNPP, and to analyze the related factors of cardiac dysfunction in patients with frequent ventricular early onset. Results 1. 91 patients (mean age 48 鹵19 years) with symptoms lasting 45 鹵16 months were selected, including 66 cases of palpitation, 23 cases of asymptomatic syncope and 2 cases of syncope. In 31 cases of shortness of breath or dizziness or fatigue, the average number of PVC in 24 hours was 19782.5 鹵11289.8) the average load of PVC and the duration of PVC-QRS wave were positively correlated with the origin of left ventricular outflow tract and negatively correlated with the origin of left ventricular outflow tract, and the time of PVC-QRS and the age of male PVC-QRS, and the mean load of PVC was 22. 5 鹵12. 7%, and the duration of PVC-QRS wave was positively correlated with the origin of left ventricular outflow tract. Compared with LVEF 鈮,
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