动态心电图长R-R间期临床分析

目的:对动态心电图中长R-R间期(房颤除外)进行临床分析,并探讨其产生的原因及临床意义。方法:回顾性分析2009年6月-2011年6月间2 500例动态心电图中65例R-R间期延长者(且R-R间期均﹥2.0 s为标准),统计导致长间歇的各类病因和心电图改变。结果:长R-R间期的总发生率为2.60%(65/2 500),50岁以上者占92.30%(60/65)。病因以冠心病、高血压多见。导致长间歇的心电图改变从高到低依次为窦性停搏43.08%(28/65),房性早搏未下传20.00%(13/65),二度Ⅱ型房室传导阻滞18.46%(12/65),二度I型房室传导阻滞10.77%(7/65),二度窦房传导阻滞3.08%(2/65),房速后代偿3.08%(2/65),三度房室传导阻滞1.54%(1/65)。结论:24小时动态心电图是长R-R间期检测的既有效又安全的方法。认识导致长R-R间期发病的病因,以及了解引起各类心电图改变的原因,对临床工作有重大的意义。

A Clinical Analysis of Ambulatory Electrocardiography with Long R-R Interval

Objective： To analyze long R-R intervals in ambulatory electrocardiography（AECG）（expect atrial fibrillation in full time）,and to probe into the significance of clinical and the cause of long interval.Methods： Retrospective analysis of 65 cases of R-R interval ≥2.0 s in 2 500 AECGs from the June 2009 to the June 2011 was made,and various types of pathogens of long R-R intervals and their electrocardiogram changes were collected.Results： The occurrence of long R-R intervals was 2.60 %（65/2 500）.Patients over 50 years old accounted for 92.30%（60/65）,and common pathogens were coronary heart disease,high blood pressure.The electrocardiogram changes which cause long intervals were ranged in descending order as sinus arrest 43.08%（28/65）,blocked premature atrial contraction 20.00 %（13/65）,artrioventricular block（Mobitz typeⅡ） 18.46 %（12/65）,artrioventricular block（Mobitz typeⅠ） 10.77 %（7/65）,sinoatrial block 3.08%（2/65）,compensatory pause after atrial tachycardia 3.08 %（2/65）,complete artrioventricular block 1.53 %（1/65）.Conclusion： 24 hours AECG is a secure and effective examination for long R-R intervals.The pathogens of long intervals and various types of electrocardiogram changes have been found out,which is significant for clinical job.