老年心脏病患者动态心电图临床分析

对39例老年心脏病无心功能不全患者进行24h 动态心电图(Holter)监测,其中肺心病缓解期(简称肺缓),高血压型心脏病(简称高心)及冠心病患者各13例.结果,肺缓组呈高基础心率、其昼夜心率无明显变化,另两组睡眠时心率明显下降(P<0.05,P<0.01),示肺缓组各时相均存在不同程度缺氧致交感兴奋;各组均检出有心律失常,全部以室性心律失常为主,高心、冠心两组睡眠时心律失常减少显著(P<0.05),肺缓组下降轻微,提示这类病人夜间易出现严重心律失常.三组均检出有心肌缺血,且均以无症状心肌缺血为主,故临床对老年心脏病人均应行 Holter 监测.

CLINICAL ANALYSIS OF THE DYNAMIC ELECTROCARDIOGRAM FOR PRESBYCARDIAC CASES

39 presbycardiac cases without cardial functional insufficiency were Holter-monitored in 24 hours:There were 13 cases of cor pulmonale in remission stage;13 cases of hypertensive cardiopathy;and 13 cases of caronary cardiopathy.The high basic heart rate appeared in the cor pulmonale group and their heart-rate no evident change were found in 24 hour.In the other 2 groups,their heart rate descended obviously during sleeping(P<0.05,P<0.01).In the cot pulmonale group,the anoxic sympathetic excitation existed in various phases arrhythmia were detected in all of the 3 groups,and the ventricular arrhythmia were found chiefly.In both hypertensive and coronary groups, arrhythmia decreased remarkably during sleeping(P<0.05)and the arrhythmia lowered slightly in cor pulmonale.It were suggested,that the serious arrhythmia always appeared at night.Myocardial ischcmia were found in all of the 3 groups,and the asymptomatic was the major.Therefore,all of the presbycardiac cases should be Holter-monitored.