左向右分流先心病心电图与肺动脉压的关系  

Relationship between mainefestaion of electrocardiogram and pressure of pulmonary artery in congenital heart disease with left to right shunt

作　　者：朱敏[1] 孙锟[1] 高伟[1] 李筠[1] 张海燕[1] 杨建萍[1] 

机构地区：[1]上海第二医科大学新华医院上海儿童医学中心心内科,上海200127

出　　处：《上海第二医科大学学报》2004年第10期851-852,共2页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的 探讨左向右分流先心病心电图表现与肺动脉压力关系,及心电图在左向右分流先心病诊断中的作用。 方法171例左向右分流先心病患者,均经心导管证实,分析心电图表现与肺动脉高压的关系。结果 1.PDA和VSD患者心电图正常或左心室肥大;合并肺动脉高压,可出现右心室肥大,与肺动脉压力正常组有显著差异(P<0.05)。2.ASD患者心电图为正常、右束支传导阻滞或右心室肥大,肺动脉压力正常组与肺动脉高压组无显著差异。3.复合左向右分流患者右心室或双心室肥大,多伴有肺动脉高压,与肺动脉压力正常组有显著差异(P<0.05)。结论 体表心电图虽能较好分析左向右分流先心病的类型.评价分流量大小及肺动脉压力情况,可作为先心病诊断中的一个重要辅助检查,但仍有一定局限性,须结合临床症状、体征和辅助检查进行综合评判。Objective To evaluate ECG in diagnosing congenital heart disease(CHD) with left to right shunt,and to explore the relationship between the mainefestation of electrocardiogram(ECG) and the pressure of pulmonary pressure (PPA). Methods We explored the relationship between the mainefestation of electrocardiogram (ECG) and the pressure of pulmonary artery pressure (PAP) in 171 patients with left to right shunt CHD, confirmed by catheteri-zation. Results 1. ECG can be normal or show left ventricular hypertrophy( LVH ) in PDA and VSD. When PPA is elevated,ECG may show biventrirular hypertrophy ( BVH ). There is significant difference between normal PPA group and elevated PPA group (P<0.05). 2. In ASD and VSD. ECG can be normal and show incomplete right bundle block ( IRBBB) ,BVH there is no significant difference. 3. In most complex GHD with left to right shunt, which are often associated with elevated PPA,ECG shows RVH( right ventricular hypertrophy) or BVH, and there is significant difference (P< 0. 05) . Conclusion ECG may play an important role in the assessment of the volume of shunt and PPA in left to right shunt CHD.

关 键 词：心电图 先心病 左向右分流 肺动脉压力 正常 肺动脉高压 患者 结论 情况 大小 

分 类 号：R541.1[医药卫生—心血管疾病]