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作 者:文川[1] 王成[1] 曹闽京[1] 李茗香[1] 林萍[1] 谢振武[1]
机构地区:[1]中南大学湘雅二医院儿科中南大学儿科学研究所,长沙410011
出 处:《实用儿科临床杂志》2006年第13期815-816,共2页Journal of Applied Clinical Pediatrics
基 金:湖南省自然科学基金项目资助(02JJY3031)
摘 要:目的评价12导联同步体表心电图(12ECGs)T波振幅在儿童扩张型心肌病(DCM)诊断和治疗中的价值。方法DCM患儿27例为研究组。男14例,女13例;年龄3个月~14岁,平均5.37岁。随机匹配健康儿童27例为对照组。受检对象描记12ECGs,测量波形清晰12导联T波振幅。其中10例DCM患儿经氢氯噻嗪、依那普利、美托洛尔、螺内酯等综合治疗后随访5~39d,平均19.67d。结果研究组较对照组T波振幅在Ⅰ、Ⅱ、aWR、aⅥJ、aⅤF、Ⅴ4、Ⅴ5、Ⅴ6导联明显降低(P均〈0.05),Ⅲ、Ⅴ2、Ⅴ,导联稍降低(P均〉0.05),Ⅴ1导联T波振幅增高(P〈0.05)。DCM患儿治疗后较治疗前T波振幅在Ⅲ、aⅤF导联明显增高(P〈0.05),Ⅱ、aWR、aⅤF、U导联稍增高(P均〉0.05),Ⅰ、aⅤL、Ⅴl~Ⅴ4、Ⅴ6导联稍降低(P均〉0.05)。结论动态观察12ECGs的T波振幅,对儿童DCM诊断和评价疗效具有客观指导价值。Objective To evaluate the clinical diagnosis and therapeutic effect of 12 - lead electrocardiographic T - wave amplitude in children with dilated cardiomyopathy(DCM). Methods 12 - lead electrocardiograms( 12 ECGs) were taken from 27 cases in children with DCM(research group) aged from 3 months to 14 years old (mean 5.37 years), 27 healthy children (control group), and 10 cases which treated with dihydrochlorothiazede enalapril spironolactone metoprolol and followed up from 5 to 39 days (mean 19.67 days). The T- wave amplitude was tested in the clear 12 ECGs. Results Compared with control group on T - wave amplitude, Ⅰ,Ⅱ, aVR, aⅤL, aⅤF, Ⅴ4, Ⅴ5,Ⅴ6 leads obviously decreased ( P〈0.05) ; Ⅲ, Ⅴ2,Ⅴ3 leads slightly decreased (P〉0.05) ; Ⅴ1 lead increased ( P 〈0.05 ). Compared with the group before treating on T- wave amplitude, Ⅲ, aⅤF leads obviously increased(P〈0.05) ; Ⅱ , aVR, aⅤF, Ⅴ5 leads slightly increased(P〉0.05) ; Ⅰ ,aⅤL,Ⅴ1 -Ⅴa,Ⅴ6 lead slightly decreased(P〉0.05). Conclusion 12 - lead electrocardiographic T- wave amplitude has the objective and leading value to clinical diagnosis and treatment in children with DCM.
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