【摘要】：目的:比較不同時程動態(tài)心電圖記錄對慢性心力衰竭患者的心律失常檢出率上的差異。方法:連續(xù)納入2016-01至2016-09在我院老年病科住院慢性心力衰竭患者108例,行連續(xù)72小時動態(tài)心電圖監(jiān)測。并進一步按紐約心臟協會(NYHA)心功能分級、左心室射血分數(LVEF)以及N末端B型利鈉肽原(NTpro BNP)水平分組,比較監(jiān)測第24小時、第48小時及第72小時室上性及室性心律失常的檢出率。結果:患者按NYHA心功能分級分:心功能Ⅱ級40例,Ⅲ級42例,Ⅳ級26例。按NT-pro BNP水平分,≥1000 pg/ml者54例,1000 pg/ml者54例。按射血分數分:射血分數保留的心力衰竭(HFp EF)80例,射血分數中間值的心力衰竭(HFmr EF)13例,射血分數降低的心力衰竭(HFr EF)15例。對短陣房性心動過速(NSAT)檢出率,監(jiān)測進行到第48小時(81.7%)與第24小時(64.6%)兩者間差異有明顯統計學意義(P0.01)。對新發(fā)陣發(fā)性心房顫動,通過24小時檢出1例,監(jiān)測至第72小時,有額外3例檢出。對短陣室性心動過速(NSVT)的檢出率,監(jiān)測進行到第72小時(38%)與第24小時(25.9%)兩者相比差異才有統計學意義(P0.01)。分組比較發(fā)現,72小時與24小時動態(tài)心電圖對于心功能Ⅲ級心力衰竭患者,對NSVT的檢出率差異有統計學意義(P0.05),但在心功能Ⅳ級患者,對NSVT的檢出率差異未見統計學意義(P0.05)。結論:長程(72小時/48小時)動態(tài)心電圖對心力衰竭患者的各類心律失常檢出率更高,但心力衰竭程度越重,24小時動態(tài)心電圖越易發(fā)現NSVT。對中重度心力衰竭患者如24小時動態(tài)心電圖未發(fā)現NSVT,可適當延長檢測時間,將有利于指導患者的臨床治療。
[Abstract]:Objective: to compare the detection rate of arrhythmia in patients with chronic heart failure (CHF). Methods: 108 patients with chronic heart failure (CHF) from January 2016 to September 2016-09 were enrolled in our department of geriatrics and were monitored by ambulatory electrocardiogram (ECG) for 72 hours. The detection rates of supraventricular arrhythmias and ventricular arrhythmias were compared at 24 hours, 48 hours and 72 hours, according to the (NYHA) cardiac function classification, left ventricular ejection fraction (LVEF) and N-terminal B-type natriuretic peptide (NTpro BNP) levels. Results: according to the classification of NYHA cardiac function, there were 40 cases of cardiac function grade 鈪，

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