致心律失常性右室心肌病患者Epsilon波的检出率  

Prevalence of Epsilon wave in patients with arrhythrnogenic right ventricular cardiomyopathy

作　　者：王静[1] 杨兵[1] 陈明龙[1] 单其俊[1] 邹建刚[1] 陈椿[1] 张凤祥[1] 侯晓峰[1] 陈红武[1] 居维竹[1] 陈凯[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心血管内科,江苏南京210029

出　　处：《中华心血管病杂志》2009年第5期413-416,共4页Chinese Journal of Cardiology

基　　金：973前期预研专项基金资助（2008CB517303）

摘　　要：目的探讨不同体表心电图记录方法对国人致心律失常性右室心肌病（arrhythmogenic righ tventricular cardiomyopathy，ARVC）患者Epsilon波检出率的影响。方法共入选ARVC患者32例，男性24例，女性8例，年龄18-70（42.3±13.3）岁。于安静仰卧位记录窦性心律情况下的标准12导联同步心电图（standard twelve leads electrocardiography，S-ECG）、右胸导联心电图（right precordial leads ECG，R-ECG）及Fontaine双极胸导联心电图（Fontaine bipolar precordial leads ECG，F-ECG）。Epsilon波判断标准为位于QRS波之后、ST段起始部的低波幅棘波、振荡波或平缓电位。结果该组病例S-ECG、R-ECG及F-ECG对Epsilon波的检出率分别为37.5％、37.5％和50.0％，三种心电图记录方法之间Epsilon波检出率的比较差异无统计学意义（均为P〉0.05）。其中1例Epsilon波仅见于S-ECG，3例仅见于R-ECG，5例仅见于F-ECG。S-ECG联合R-ECG的检出率为50.0％，S-ECG联合F-ECG的检出率为56.3％，三种记录方法的联合检出率为65.6％，S-ECG联合F-ECG的检出率与S-ECG相比明显提高（P〈0.05），联合三种心电图记录方法的检出率与S-ECG相比有显著提高（P〈0.01）。结论联合使用S-ECG、R-ECG及F-ECG三种心电图记录方法，可以显著提高ARVC患者Epsilon波的检出率，且三种记录方法之间可以相互补充。Objective To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventricular cardiomyopathy （ARVC）. Methods The Epsilon wave was detected in 32 patients [24 men, mean age （42.3±13.3） years] with ARVC using three different electrocardiography （ECG） recording methods： standard twelve leads ECG （S-ECG）, right precordial leads ECG （R-ECG） and Fontaine bipolar precordial leads ECG （F-ECG）. The Epsilon wave was defined as wiggle, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segmenL Results Epsilon wave was detected in 37.5%, 37.5% and 50. 0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar（P 〉 0.05）. The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50. 0% by combined use of S-ECG and R-ECG （ SR- ECG）, 56.3% by combined use of S-ECG and F-ECG （ SF-ECG）, and 65.6% by combined use of the three recording methods （SRF-ECG）. The detection rate was significantly higher by SF-ECG （56.3%） and SRF-ECG （65.6%） than by S-ECG alone （37.5%, all P 〈0.05）. Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves. Conclusion Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.

关 键 词：心律失常性右心室发育不良 心电描记术 EPSILON波 

分 类 号：R686[医药卫生—骨科学]