摘要
目的:探讨普通室早合并插入性室早的散点图特征及其形成原理,为快速分析动态心电图奠定基础。方法:回顾性分析2017年1月至2023年12月在郑州大学第二附属医院门诊、住院期间动态心电图诊断为室性早搏的193例患者的临床资料,将入选患者分为四组:A组(单纯普通室早,60例),B组(单纯插入性室早,13例),C组(普通室早合并插入性室早,120例),其中插入性室早不伴干扰性PR间期延长为C1组(70例),插入性室早伴干扰性PR间期延长为C2组(50例)。分析比较四组患者的一般临床资料及散点图形态特征。结果:四组患者年龄、心室率比较差异有统计学意义(P<0.05);四组患者性别、心搏总数、室早比例、心率变异性(SDNN)比较差异未见统计学意义(P>0.05)。亚组比较中,A组、C1组年龄比较差异有统计学意义(P<0.05);A组与B组、A组与C1组、A组与C2组、B组与C1组、B组与C2组心室率组间比较差异有统计学意义(P<0.05)。C1组与C2组心室率比较差异未见统计学意义(P>0.05)。Lorenz散点图特点:C组呈现A组+B组Lorenz散点图特点之和,C2组较C1组增加N’NN点集,C1组VN’N点集主轴斜率约等于1,C2组VN’N点集主轴斜率大于1或垂直。差值散点图特点:C组呈现A组+B组差值散点图特点之和,并增加两种室早交替形成的VNVN’点集及VN’VN点集,与C1组相比,C2组NNVN’点集略上移、NVN’N点集右下移、VN’NN点集左上移,NNNN右侧分离出N’NNN点集,NNNV点集右侧分离出N’NNV点集。结论:普通室早合并插入性早搏的心电散点图特征明显、规律性强,插入性室早是否合并干扰性PR间期延长的散点图特点既有相似又有不同,掌握其散点图特点,有利于此类动态心电图快速分析。
Objective:To investigate the features of scatter diagram of common ventricular premature beat complicated by interpolated ventricular premature beat and the causes of them,so as to lay foundations for quickly analysis of ambulatory electrocardiography.Methods:The clinical data of 193 patients diagnosed with ventricular premature beat by 24-hour Holter during out-patient and in-patient period in the Second Affiliated Hospital of Zhengzhou University from January 2017 to December 2023 were retrospectively analyzed.And the patients were divided into four groups:group A(60 cases with only common ventricular premature beat),group B(13 cases with only interpolated ventricular premature beat),group C(120 cases with common ventricular premature beat complicated by interpolated ventricular premature beat).In the group C,70 cases without intrusive interval from the onset of atrial depolarization to the beginning of ventricular depolarization(PR interval)prolonged were enrolled in the group C1,and 50 cases with intrusive PR interval prolonged were enrolled in the group C2.The general clinical data and characteristics of scatter diagram of the four groups were analyzed and compared.Results:There were significant differences in age and ventricular rate among the four groups(P<0.05),but there was no significant difference in gender,total heart beat,ratio of ventricular premature beat and standard deviation of all normal to normal R-R intervals(SDNN)among the four groups(P>0.05).There were statistically significant differences in age between group A and group C1(P<0.05);and there were statistically significant differences in mean ventricular rate between group A and group B,between group A and group C1,between group A and group C2,between group B and group group C1,and between group B and group C2(P<0.05).There were no significant differences between group C1 and group C2(P>0.05).Group C presented the sum of Lorenz scatter plot features of group A and group B,group C2 had increased N’NN point set compared with group C1;in group C1,the VN’N spindle slope was approximately equal to 1;in group C2,the VN’N spindle slope was greater than 1 or vertical.Difference scatter plot features of group C was the sum of Lorenz scatter plot features of group A and group B,accompanied by the VNVN’and VN’VN point set formed by the two types of ventricular premature beat alternating.Compared with group C1,the NNVN’point set in group C2 moved slightly upward,the NVN’N point set moved right down,the VN’NN point set moved left up,and the N’NNN point set was separated from the right side of NNNN.The N’NNV point set was separated from the right of NNNV point set.Conclusions:The features of scatter diagram of common ventricular premature beat complicated by interpolated ventricular premature beat are obvious and regular.The features of interpolated ventricular premature beat with or without intrusive PR interval prolongation have similarity and difference.Mastering the scatter diagram characteristics is conducive to the rapid analysis of ambulatory electrocardiography of the disease.
作者
申继红
景永明
王苏萌
聂连涛
黄菊香
李世锋
Shen Jihong;Jing Yongming;Wang Sumeng;Nie Liantao;Huang Juxiang;Li Shifeng(Department of Electrocardiogram,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《中国实用医刊》
2024年第13期1-5,共5页
Chinese Journal of Practical Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20220435)。
关键词
动态心电图
LORENZ散点图
差值散点图
普通室性早搏
插入性室性早搏
干扰性PR间期延长
Electrocardiography,ambulatory
Lorenz plots
Difference scatter plot
Common ventricular premature beat
Interpolated ventricular premature beat
Intrusive PR interval prolonged
