【摘要】 目的观察恢复期亚急型和慢型克山病患者动态心电图(DCG)特点,探讨其预后意义。方法选择恢复期亚急型和慢型克山病患者88例,进行心电图(ECG)和DCG检查,并长期随访,以观察终点结果死亡或存活分组对比分析。结果恢复期亚急型克山病患者在ECG 90.3%正常情况下,84.9%的DCG出现异常。慢型ECG及DCG异常检出率都很高,分别为94.7% 和100.0%。亚急型DCG异常检出率室早最高,为77.4%,其中成对室早51.6%,室速32.3%;房早次之41.9%。慢型DCG异常检出率室早最高,为96.5%,其中频发室早75.4%,成对室早51.6%,室速32.3%;房早次之82.2%。死亡组与存活组对比,死亡组ECG房早、室早、ST鄄T改变较存活组检出率高(P<0.05)。死亡组与存活组DCG室早总检出率无差异(P>0.05),但成对室早和室速检出率较存活组高(P<0.05)。结论房性与室性心律失常是恢复期亚急型和慢型克山病的DCG特征,亚急型ECG正常,DCG高异常检出率;慢型ECG及DCG均高异常检出率。成对室早和室速对预后有重要意义。更多还原

【Abstract】 Objective To observe the clinical features and to explo re prognostic meanings of dynamic electrocardiogram on recover-term subacute and chronic Keshan disease.Methods Thirty-one recover-term subacute patents and57chronic Keshan patents were selected from Shandong epidemic area of Keshan disease.They were checked up by electrocardiogram(ECG)and dynamic electrocardiogram(DCG)and were followed-up for long term.All patents were divided into2groups(survive and death groups),which were analysed by comparative methods.Results Normal ECG was90.3%and subnormal DCG was84.9%in recover-term subacute patents.The incidence rate of subnormal ECG and DCG were all high in chronic Keshan disease.The incidence rate of ventricular premature was77.4%,frequent ventricular premature25.8%,pair ventricular premature51.6%,ventricular tachycardia32.3%in subnormal DCG of recover-term subacute patents.The incidence rate of ventricular premature was96.5%,frequent ventricular premature75.4%,pair ventricular premature77.2%,ventricular tachycardia59.6%,atrial premature82.2%in subnormal DCG of chronic patents.The subnormal DCG on survive groups was compared with death groups.The incidence rate of atrial premature,ventricular premature and ST-T change in subnormal ECG of were higher than that in survive groups(P<0.05).The incidence rate of frequent ventricular premature,pair ventricular premature and ventricular tachycardia of DCG in death groups were higher than that in survive groups(P<0.05).Conclusions The atrial and ventricular cardiac arrhythmia are the features of ECG and DCG in recover-termsubacute and chronic Keshan disease.ECG is normal,DCG subnormal in recover-term subacute patents but ECG and DCG are all subnormal in chronic patents.The pair ventricular premature and ventricular tachycardia are important for prognosis.更多还原