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目的:探讨时间散点图在临床用于诊断心房颤动伴Ⅱ度房室传导阻滞的实用性及可靠性。方法:回顾性分析2014年5月至2016年2月在信宜市人民医院诊断为持续性房颤的120例患者,根据诊断结果分为3组,其中第1组为单纯的持续心房颤动(60例),而第2组为心房颤动伴Ⅱ度房室传导阻滞(20例),第3组则是持续房颤+心室起搏(40例)。结果:第1组患者时间散点图的条带出现增宽现象,上缘是云雾形态,下缘是带状或波浪状形态;第2组患者的时间散点图上界明显,并且界限是在RR间期内(1.5~1.8 s),下缘为点状或者云雾状;第3组时间散点图的界线在RR间期<1.2 s的区间内,下缘也呈现云雾的形态。对3组患者的图像进行对比分析发现,第2组上界明显;第3组患者的年龄要明显高于第1组、第2组,而第2组患者年龄又明显高于第1组,组间比较,差异具有统计学意义(P<0.05)。而3组患者的组间男性、女性比例差异均无统计学意义(P>0.05)。结论:24 h动态图心电图的时间散点图往往具有明显的上界,同时其上界的界线一般是位于RR间期内的1.5~1.8 s区间,因此可以将该区间内的界线作为诊断持续房颤伴有Ⅱ度房室传导阻滞的重要的参考依据。
Objective: To explore the practicality and reliability of time scattergraph in the clinical diagnosis of atrial fibrillation with degree Ⅱ atrioventricular block. Methods: A retrospective analysis of 120 patients diagnosed as persistent AF from May 2014 to February 2016 in Xinyi Municipal People’s Hospital was divided into three groups according to the diagnosis results. The first group was simple persistent atrial fibrillation 60 cases), group 2 was atrial fibrillation with degree Ⅱ atrioventricular block (n = 20), group 3 was continuous atrial fibrillation + ventricular pacing (40 cases). Results: In the first group of patients, the time-scatter band appeared widened. The upper edge was cloud-shaped and the lower edge was banded or wavy. The upper part of the time-series scatter chart of the second group of patients was clearly defined and the limit was In the RR interval (1.5-1.8 s), the lower edge was point-like or cloud-like. The boundary of the scatter plot of the third group showed a cloud shape in the interval of <1.2 s RR interval. The comparative analysis of the images of the three groups showed that the upper boundary of group 2 was obvious; the age of group 3 was significantly higher than that of group 1 and group 2, while the age of group 2 was significantly higher than that of group 1, The differences between groups were statistically significant (P <0.05). There was no significant difference in the proportions of males and females between the three groups (P> 0.05). CONCLUSION: The time-scatter plot of 24-hour dynamic electrocardiogram often has a clear upper bound, and the boundary of its upper bound is generally within the range of 1.5-1.8 s within the RR interval. Therefore, the boundary within this interval can be regarded as a diagnosis Atrial fibrillation with Ⅱ degree atrioventricular block important reference.