ABSTRACT
Objective To investigate the sensitivity and specificity of conventional 12 lead electrocardiogram(ECG)and 24h dynamic ECG in patients with pacemaker implantation.Methods From May 2016 to May 2017,65 patients with pacemaker implantation in Heji Hospital Affiliated to Changzhi Medical College were selected.All patients were examined by two methods of routine 12 lead ECG and 24h dynamic ECG.The arrhythmia detection results,as well as sensitivity,specificity,accuracy and other indicators were observed and compared in the two groups.Results The positive rate of arrhythmia detected by 24h dynamic ECG was 96.9％,which was higher than 53.8％of the 12 lead ECG,the difference was statistically significant(χ2 =5.182,P <0.05).The detection rates of atrioventricular block,premature ventricular premature beat and premature atrial premature beat in 24h dynamic ECG group were higher than those of routine 12 lead ECG group,the differences were statistically significant(χ2 =8.615,P<0.05).The monitoring specificity,sensitivity and accuracy of 24h dynamic ECG were 96.9％,95.4％and 95.4％,respectively,which were higher than those of the conventional 12 lead ECG(58.5％,61.5％and 53.8％),the differences were statistically significant(all P<0.05).Conclusion The detection rate of arrhythmia in patients with pacemaker implantation by 24 h Holter is higher than that of routine 12 lead ECG,and its accuracy,specificity and sensitivity are higher,and it is safe and reliable,it is worthy of popularizing in the clinic.
ABSTRACT
Objective To investigate the prevention of stroke-associated pneumonia (SAP) with Ramipril.Methods 404 acute stroke patients with primary hypertension were randomized into two groups.Group A received ramipril 2.5 mg once daily orally,and then were titrated up to 5 mg/d after a week.Group B received Candesartan 4 mg once daily orally,and then were titrated up to 8 mg/d after a week.The treatment course was 28 days.All patients received examination of Standardized Swallowing Assessment (SSA).The amelioration of swallow function and incidence of SAP after treatment were compared between the two groups.Results There were 10 patients suffering from SAP in group A and 21 patients in group B.The incidence of SAP was lower in group A(5.0％)than in group B(10.4％)(P＜0.05).The positive rate of SSA was 87.1 ％ in patients with SAP,higher than the total rate (47.5％).Dysphagia was improved in both groups after treatment.The rate of dysphagia improvement in group A and group B was 81.4％ and 66.3％ respectively.There was significant statistics difference in the positive case of SSA between two group (P＜ 0.05).Conclusions Orally treatment with ramipril is effective to prevent stroke-associated pneumonia and toimprove swallow function.