高龄孕妇孕早期心律失常及转归分析

目的：观察高龄孕妇孕早期ECG异常及心律失常发生特点，记录孕早期房性及室性心律失常的后期转归情况。方法：290例孕妇按照年龄分为35岁以下组，35~39岁组和40~45岁组。行心电图检查，系统分析心电图波形，采集记录异常心电图变化，包括ST段改变、各型心律失常等，记录房性、室性心律失常的好转率及加重率。结果：35~39岁组和40~45岁组心律失常发生率显著高于35岁以下组（P<0.05）；35~39岁组和40~45岁组ST段异常发生率显著高于35岁以下组（P<0.05）；40~45岁组QRS波增宽发生率高于35岁以下组（P<0.05）。35~39岁组和40~45岁组的窦性心动过速、窦性心律不齐和房性早搏发生率显著低于35岁以下组（P<0.05）；40~45岁组阵发性室上速发生率显著高于35岁以下组（P<0.05），35~39岁组和40~45岁组室性早搏和房颤发生率均显著高于35岁以下组（P<0.05）。40~45岁组的房性心律失常恢复率显著低于35岁以下组（P<0.05）；40~45岁组的房性和室性心律失常加重率显著高于35岁以下组（P<0.05）。35~39岁组的ECG异常组、40~45岁ECG异常组发生率显著高于35岁以下组和35~39岁组的ECG正常组（P<0.05）；35~39岁组及40~45岁的ECG异常组胎儿窘迫发生率显著高于35岁以下组（P<0.05）。结论：高龄与孕早期心律失常发生有正相关，并且高龄因素降低孕期心律失常自行恢复率而升高心律失常恶化发生率，高龄孕妇伴有心电图异常对围生儿状况有不良影响。

Analysis of arrhythmia and recovering in early stage pregnancy of older pregnant women

Objective: To observe the abnormality of the electrocardiogram (ECG) and the characteristics of arrhythmia in the early stage of older pregnant women and to record the late outcome of atrial and ventricular arrhythmia.Methods: Two hundrend and ninty pregnant women were divided into 3 groups by age under 35 group, 35~39 group and 40~45 group. The ECG waveform was analyzed systematically when the patients were subjected to routine ECG examination and abnormal changes of ECG were collected and recorded, including ST segment changes, various arrhythmias, etc. Then the recovery and deterioration rate of atrial, ventricular arrhythmia was recorded.Results: The incidence of arrhythmia in 35~39 group and 40~45 group was significantly higher than under 35 group (P<0.05); the incidence of abnormal ST section in 35~39 group and 40~45 group was significantly higher than under 35 group(P<0.05); and the incidence of widened QRS wave in 40~45 group was higher than under 35 group (P<0.05). The incidence of sinus tachycardia, sinus irregularityand atrial premature beats in 35~39 group and 40~45 group was obviously lower than that under 35 group (P<0.05); the incidence of Paroxysmal supraventricular tachycardia in 40~45 group was obviously higher than under 35 group (P<0.05) and the incidence of ventricular premature beat and atrial fibrillation in 35~39 group and 40~45 group was significantly higher than under 35 group (P<0.05). The recovery rate of atrial arrhythmia in 40~45 group was obviously lower than under 35 group (P<0.05);the exacerbation rate of trial and ventricular arrhythmia in 40~45 group was obviously higher than over 35 group (P<0.05). The incidences of IUGR in 35~39 group and 40~45 group with abnormal ECG was obviously higher than under 35 group and 35~39 group with normal ECG; The incidences of fetal distress in 35~39 year-old group and 40~45 year-old group with abnormal ECG was obviously higher than under 35 group(P<0.05).Conclusion: There is a positive correlation between the old age and the incidence of arrhythmia in the early stage of pregnancy, and old age factors can reduce the recovery rate but increase the incidence of deterioration of arrhythmia. And older pregnant women with abnormal ECG have undesirable effect to perinatal infant.