Abstract:

Objective　To compare the effects of conventional electrocardiogram (ECG) and dynamic electrocardiogram (DCG) in the diagnosis of cardiogenic syncope in the elderly. Methods　A total of 110 elderly patients with suspected cardiogenic syncope admitted to Binzhou Central Hospital from June 2020 to May 2021 were selected for conventional ECG and DCG examinations, including 62 males and 48 females, aged (76.07±6.15) years. The diagnostic accuracy, sensitivity, and specificity of the two examinations were compared, as well as the detection rates of arrhythmia in patients with positive and negative cardiogenic syncope. The count data were tested by χ² test. Results　Among 110 elderly patients with suspected cardiogenic syncope, 88 cases (80.00%) were finally diagnosed as positive, and 22 cases (20.00%) were negative. In the diagnosis of elderly patients with suspected cardiogenic syncope, the diagnostic accuracy, sensitivity, and specificity of DCG [90.91% (100/110), 93.18% (82/88), and 81.82% (18/22)] were significantly higher than those of conventional ECG [63.64% (70/110), 72.73% (64/88), and 27.27% (6/22)], with statistically significant differences (all P<0.05). The detection rate of arrhythmia types diagnosed by DCG in elderly patients with cardiogenic syncope was significantly higher than that by conventional ECG, with statistically significant differences (all P<0.05). Conclusions　In the diagnosis of cardiogenic syncope in the elderly, the diagnostic accuracy, sensitivity, and specificity of DCG are higher than those of conventional ECG, the detection rate of arrhythmia is more accurate and efficient, and the clinical diagnosis effect is more ideal.

Key words: Cardiogenic syncope in the elderly, Dynamic electrocardiogram, Diagnosis

摘要： 目的　对比研究常规心电图与动态心电图诊断老年心源性晕厥的效果。方法　选取2020年6月至2021年5月滨州市中心医院收治的疑诊心源性晕厥的老年患者110例，其中男62例、女48例，年龄（76.07±6.15）岁，均行常规心电图与动态心电图检查。对比2种检查诊断的准确度、灵敏度、特异度以及心源性晕厥阳性、阴性患者心律失常检出率。计数资料采用χ²检验。结果　110例疑诊老年心源性晕厥患者中最终确诊88例（80.00%）为阳性，22例（20.00%）为阴性。在对疑诊老年心源性晕厥患者检查诊断中，动态心电图检查诊断准确度、灵敏度及特异度分别为90.91%（100/110）、93.18%（82/88）、81.82%（18/22），均明显高于常规心电图63.64%（70/110）、72.73%（64/88）、27.27%（6/22），差异均有统计学意义（均P<0.05）。动态心电图检查诊断老年心源性晕厥心律失常类型检出率均明显高于常规心电图检查，差异均有统计学意义（均P<0.05）。结论　在老年心源性晕厥诊断中，动态心电图检查的诊断准确度、灵敏度及特异度较常规心电图更高，心律失常的检出率更加精准且效率更高，临床诊断效果更为理想。

关键词: 老年心源性晕厥, 动态心电图, 诊断