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[职业医学中的连续心电图记录]

[Continuous electrocardiographic registration in occupational medicine].

作者信息

Massin N, Meyer-Bisch C, Lacube P, Castet P, Ouvrard C, Mur J M, Cavelier C

出版信息

Arch Mal Coeur Vaiss. 1984 Feb;77(2):203-11.

PMID:6424604
Abstract

Continuous 24 hour electrocardiography (Holter method) was carried out during work time in 64 workers. They were divided into two groups: the first group comprised 34 subjects with either organic heart disease (coronary artery disease, valvular heart disease, operated coarctation, hypertrophic cardiomyopathy) or a documented arrhythmia without proven underlying cardiac disease; the second group comprised 30 subjects without known cardiac disease but complaining of symptoms suspected to be of cardiac origin or with isolated electrocardiographic abnormalities. At the end of the study we concluded that Holter monitoring is possible in subjects performing physical occupations even in difficult conditions. The trends of heart rate, especially mean heart rate calculated over 10 minute periods, confirmed the relationship between heart rate and the intensity of the physical activity. Atrial extrasystoles and episodes of supraventricular tachycardia were as common in the first as in the second group (20% and 18% respectively). This did not apply to ventricular extrasystoles: they were observed in both groups but were significantly more common in the first group (55% compared to 33%); ventricular extrasystoles, usually of a single configuration and isolated, were more common in the first group, especially amongst the coronary patients. Sinus node dysfunction was only observed in the second group (12.5%), in young subjects, and this occurred with only one exception at night. These findings support previous reports in the literature. However, the interpretation of these results is difficult because of the absence of well established normal values.

摘要

在64名工人的工作时间内进行了连续24小时心电图监测(动态心电图法)。他们被分为两组:第一组包括34名患有器质性心脏病(冠状动脉疾病、心脏瓣膜病、手术治疗的主动脉缩窄、肥厚型心肌病)或有记录的心律失常但无潜在心脏病证据的受试者;第二组包括30名无已知心脏病但主诉有疑似心脏源性症状或有孤立心电图异常的受试者。在研究结束时,我们得出结论,即使在困难条件下,从事体力劳动的受试者也可以进行动态心电图监测。心率趋势,尤其是在10分钟时间段内计算出的平均心率,证实了心率与体力活动强度之间的关系。第一组和第二组的房性期前收缩和室上性心动过速发作发生率相同(分别为20%和18%)。室性期前收缩情况不同:两组均有观察到,但第一组明显更常见(分别为55%和33%);室性期前收缩通常为单一形态且孤立出现,在第一组更常见,尤其是在冠心病患者中。窦房结功能障碍仅在第二组(12.5%)的年轻受试者中观察到,且仅在夜间出现过一次例外情况。这些发现支持了文献中先前的报道。然而,由于缺乏公认的正常值,这些结果的解释存在困难。

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