心房异构心电图特征的分析  

Analysis of electrocardiographic characteristics of atrial isomerism

作　　者：邢海华[1] 黄美蓉[1] 聂云章[1] 周弋[1] 屈顺梅[1] 

机构地区：[1]上海交通大学医学院附属新华医院儿童医学中心,200127

出　　处：《临床心电学杂志》2008年第1期37-39,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨心房异构心电图特征及临床意义。方法对比分析126例心房异构先心病(其中右房异构95例,左房异构31例)和心房位置正常的先心病(法洛四联症、大动脉转位、复杂型紫绀型先心病各120例)患者的心电图。结果心房异构先心病异位心律的发生率为66.7%,心房正常组为1%～9%,右房异构中窦性心律占41%,异位心律以左房心律、游走心律多见,分别占24%及28%;左房异构窦性心律占9.7%,异位心律以低位房性心律、交界区心律多见,占61%。心房异构与心房结构正常的复杂型先心病之间及两种不同类型的心房异构之间心电图表现均存在显著差异(p<0.01)。结论心房异构异位心律发生率明显高于心房位置正常者。右房异构以窦性心律、左房心律、游走心律多见,左房异构以低位房性心律、交界区心律为主。Objective To evaluate electrocardiogram diagnosis and significance of atrial isomerism. Methods Standard electrocardiograms were reviewed to compare the 126 patients with the isomerism in atrial appendage （95 with fight isomerism and 31 with left isomerism） to those with other congenital heart diseases of normal atrial situs （120 with tetralogy of Fallot, 120 with transposition of the great arteries and 120 with complex cyanosing congenital heart diseases）. Results The incidence of ectopic rhythm was 66,7% in atrial isomerism group and 1%-9% in the control group. Of the right isomerism, 41% had sinus rhythm and 24% had left atrial rhythm, 28% wandering rhythm,which were more frequent in ectopic rhythm. Of the left isomerism, 9.7% had sinus rhythm and 61% had low-site atrial rhythm or atrioventricular junctional rhythm. There are significant differences between electrocardiograms with isomerism of the atrial appendage and other complex congenital heart diseases with normal atrial situs （p〈0.01）, also between electrocardiograms with right and left atrial isomerism （P〈0.01）. Conclusions Ectopic rhythm was significantly more frequent in atrial isomerism than normal atrial situs. Sinus rhythm, left atrial rhythm and wandering rhythm were more frequent in the right isomerism, but low-site atrial or atrioventricular junctional rhythm were more frequent in the left isomerism.

关 键 词：心房异构 异位心律 先天性心脏病 

分 类 号：R540.4[医药卫生—心血管疾病]