改良心脏固有心率测定诊断窦房结功能障碍

黄静瑜; 黄启祥; 罗桥根; 方红

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改良心脏固有心率测定诊断窦房结功能障碍

临床研究 | 更新时间：2025-10-15

- 改良心脏固有心率测定诊断窦房结功能障碍
- Application value of modified intrinsic heart rate in the diagnosis of sinoatrial node dysfunction
- 临床心电学杂志 2022年第2期页码：98-101
- 作者机构：
  
  广东省江门市中心医院
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R540.4;R541.7
- 纸质出版：2022
- 稿件说明：
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黄静瑜, 黄启祥, 罗桥根, 等. 改良心脏固有心率测定诊断窦房结功能障碍[J]. 临床心电学杂志, 2022,(2):98-101.

Huang jingyu, Huang qixiang, Luo qiaogen, et al. Application value of modified intrinsic heart rate in the diagnosis of sinoatrial node dysfunction[J]. 2022, (2): 98-101.
黄静瑜, 黄启祥, 罗桥根, 等. 改良心脏固有心率测定诊断窦房结功能障碍[J]. 临床心电学杂志, 2022,(2):98-101. DOI：

Huang jingyu, Huang qixiang, Luo qiaogen, et al. Application value of modified intrinsic heart rate in the diagnosis of sinoatrial node dysfunction[J]. 2022, (2): 98-101. DOI：

摘要

目的探讨改良固有心率测定在窦房结功能障碍诊断中的作用。方法收集我院2018年1月至2019年5月的心电生理室30例住院患者资料，根据病史、症状、动态心电图检查及临床诊断结果分为单纯窦性心动过缓（A组）和病态窦房结综合征组（B组）。使用改良心脏固有心率测定方法测定两组患者的心脏固有心率，分别记录阿托品和艾司洛尔使用后各时点的心率水平，用ROC曲线对比改良试验和阿托品试验结果，并用相关性分析探讨预测值与测量值之间的相关性。在对两组患者进行随访过程中再次用改良测定试验进行对比评估。结果 A组患者用改良方法测定的固有心率值为85.75±8.90次/分，B组为72.50±6.38次/分，两组差异有统计学意义（p<0.001），注射艾司洛尔后的心率记录结果显示两组在各时点下均有显著性差异。ROC曲线结果显示，改良试验的曲线下面积（AUC）为0.887(95%可信区间：0.770-1.000)，比阿托品高[AUC:0.788(95%可信区间：0.606-0.969)]。改良试验测量值与预测值之间的对比显示两者不相关（p=0.814）。用改良试验对随访数据进行对比评估，1年后患者测量值没有显著变化。结论改良心脏固有心率测定对窦房结功能障碍有鉴别诊断作用，其特异性及敏感性优于阿托品试验，有助于筛查出窦房结功能障碍的患者，从而指导临床治疗。

Abstract

Objective To investigate the role of improved intrinsic heart rate in the diagnosis of sinoatrial node dysfunction. Methods Thirty patients were studied in our research

whose data were collected in the department of electrophysiology from January 2018 to May 2019. According to the medical history

symptoms

ambulatory ECG and clinical diagnosis results

they were divided into simple sinus bradycardia（group A） and sick sinus syndrome group（group B）. The intrinsic heart rate of the two groups was measured by the improved intrinsic heart rate measurement method

and the heart rate levels at each time point after Atropine and Esmolol were recorded respectively. The results of the improved test and atropine test were also compared by ROC curve with the Astropine test

and the correlation between the predicted value and the measured value was discussed by correlation analysis. During the follow-up of the two groups of patients

the modified test was used for comparative evaluation again. Results The intrinsic heart rate measured by the improved method was 85.75 ± 8.90bpm in group A and 72.50 ± 6.38bpm in group B. There was significant difference between the two groups（p<0.001）. The heart rate recording results after Esmolol injection showed that there were significant differences between the two groups at each time point. The ROC curve showed that the area under the curve of modified test was 0.887（95% CI: 0.770-1.000）

which was higher than atropine test（0.788

95%CI:0.606-0.969）. The comparison between the measured and predicted values of the improvement test showed that they were not correlated（p=0.814）. It was found that no significant change in the patient’s measurement after 1 year when comparing and evaluating follow-up data by the modified test. Conclusions The improved intrinsic heart rate measurement has a differential diagnostic role in the diagnosis of sinoatrial node dysfunction. Its specificity and sensitivity are better than atropine test

and it can help to screen patients with sinoatrial node dysfunction and guide clinical treatment.

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references

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