老年人支气管哮喘急性发作期与稳定期24小时动态心电图变化

目的:观察老年人支气管哮喘急性发作期与稳定期24小时动态心电图变化。 方法: 老年支气管哮喘患者76（男54，女22）例。年龄60~89（74±8）岁。哮喘病史2~31（12±9）年。哮喘发作期安放24小时动态心电图；稳定2周后再做24小时动态心电图。结果: 哮喘发作期与稳定期24小时动态心电图中最高心率［(142±31)次/min vs.(113±17)次/min］、最低心率［(76±9)次/min vs.(54±11)次/min］、平均心率［(95±16)次/min vs.(73±13)次/min］、室上早次数［(353±72)次/24h vs.(92±37)次/24h、室早次数［(327±75)次/24h vs.(98±27)次/24h］、室上速发生率(91% vs. 20%)、房颤发生率（37% vs. 16%）、ST-T改变发生率（78% vs. 30%）和J波发生率（28% vs. 5%）均显著增多或增高（P<0.05或P<0.01）。结论: 哮喘发作期较稳定期可诱发多种心律失常和心电图改变。

Study on 24-h dynamic electrocardiogram changes of senile bronchial asthma during acute period and stable period in elderly patients

AIM:To examine 24-h dynamic electrocardiogram changes of senile bronchial asthma during acute and stable periods in elderly patients. METHODS: Seventy-six patients (54 male, 22 female) aged 60-89(74±8) years were included in this study. Patients had a history of asthma between 2 and 31(12±9) years. Twenty-four-hour dynamic electrocardiogram was performed, respectively, during acute period and 2 weeks after the stable period. RESULTS: There were significant differences in maximum heart rate ［(142±31) vs.(113±17) 1/min］, minimum heart rate ［(76±9) vs.(54±11) 1/min］, mean heart rate ［(95±16) vs.(73±13) 1/min］, supraventricular premature beats ［(353±72) vs.(92±37) 1/24 h］, ventricular premature beats ［(327±75) vs.(98±27) 1/24 h］, supraventricular tachycardia cases (69 vs. 15), atrial fibrillation cases (28 vs. 12), ST-T change cases (59 vs. 23) and J-wave cases (21 vs. 4) between acute and stable periods (P<0.05 or P<0.01). CONCLUSION: Asthma during acute period can induce varied electrocardiogram changes and arrhythmia, possibly due to anoxia, catecholamine increase, right ventricular hypertrophy, and acid-base and electrolyte disorders.