冠心病室性心动过速无人区电轴的研究  

Clinical study of axis of ″no man's land″ in patiens of coronary heart disease with ventricular tachycardia

作　　者：赵素焕[1] 郭继鸿[1] 卢喜烈[2] 赵京[1] 季骁玲[1] 张海澄[1] 

机构地区：[1]北京大学人民医院,100044 [2]解放军总医院,100853

出　　处：《临床心电学杂志》2006年第3期186-188,共3页Journal of Clinical Electrocardiology

基　　金：北京大学985基金资助

摘　　要：目的探讨冠心病室速无人区电轴发生率及无人区电轴临床应用价值。方法对确诊冠心病并在常规心电图或12导联同步动态心电图记录到室性心动过速的72例患者,应用振幅法测量QRS额面电轴,比较室速发作时电轴与其窦性心律时电轴的差值,心肌梗死组、不稳定性心绞痛组电轴的差值,以及无人区电轴组与非无人区电轴组二者差值。结果87阵室速中23阵心电轴位于无人区,发生率无显著性别差异(p>0.05)。无人区电轴发生率右束支阻滞型室速高于左束支阻滞型室速(p<0.01),心肌梗死组室速高于不稳定性心绞痛组(p<0.05),不同部位心肌梗死无人区电轴发生率无统计学差异(p>0.05)。室速发作时与窦性心律电轴的差值为101.86±55.51°,其中差值>40°者72阵(82.76%)。结论冠心病患者宽QRS心动过速时新出现无人区电轴,或室速与窦性心律电轴差值>40°可做为鉴别诊断的重要指标。Objective To analyze the QRS axis characteristic of ventricular tachycardia （VT） with coronary heart disease. Methods Eighty-seven episodes of VT in 72 patients with coronary heart disease （CHD） were included in this study. Twelve-lead electrocardiogram （ECG） or dynamic ECG were available in all patients and only monomorphic VT was considered. The algebraic sum of the deflections in leads Ⅰ and Ⅲ was used to plot the QRS axis. Results The frontal plane axis of ＂no man＇s land＂ of 12-lead body surface ECG appeared in 20 RBBB pattern VT and 3 LBBB pattern VT. The incidence rate of axis of ＂no man＇s land＂ is 26,44%, which in RBBB pattern VT is much more than that of LBBB pattern VT （P〈0.01）, in myocardia infarction （MI） patients is significantly higher than that in unstable angina patients （P〈0.05）, but there is no Significant difference between MI location and gender. Conclusion The new onset of axis of ＂no man＇s land ＂ or the obviously axis change （〉 40°） after VT can be an important index in differential diagnosis of wide QRS complex tachycardia in CHD patients,

关 键 词：冠心病 室性心动过速 无人区电轴 

分 类 号：R541.4[医药卫生—心血管疾病]