碎裂QRS波在致心律失常性右心室心肌病诊断中的价值  

Diagnostic value of fragmented QRS complex in patients with arrhythmogenic right ventricular cardiomyopathy

作　　者：周秀娟[1] 杨兵[1] 王静[1] 陈明龙[1] 张凤祥[1] 居维竹[1] 陈红武[1] 王本琪[1] 丰尚鹏[1] 丁祥伟[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏中心,210029

出　　处：《中华心律失常学杂志》2011年第1期23-26,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：基金项目：国家自然科学基金（81070158）

摘　　要：目的评价碎裂QRS波（fQRs波）在致心律失常性右心室心肌病（ARVC）诊断中的价值。方法43例符合ARVC诊断标准的患者，男性33例，平均年龄（40．4±13．9）岁。采集临床资料，记录静息状态下标准12导联心电图，描述fQRs波的心电图特征，判断是否存在fQRs波、epsilon波和右胸前导联T波倒置（TWI）并比较其阳性率之间的差异。结果本组患者fQRs波以下壁导联（44．3％）和右胸前导联（24．2％）最为多见。QRS波中，fQRs波见于R波者多于S波者（58．4％对32．9％，Z=4．30，P〈0．01）。共31例患者判断为fQRS波阳性，2～9（4．6±1．7）个／例。fQRs波阳性率较epsilon波（73．8％VS30．2％，Z=3．67，P〈0．01）和TWI（73．8％对41．9％，Z=2．61，P〈0．01）显著增高。结论fQRs波阳性是ARVC患者常见的心电图异常，常见于下壁和右胸前导联，可作为提示诊断的无创心电指标。Objective To evaluate diagnostic value of fragmented QRS complex （fQRS）in patients with arrhythmogenic right ventricular cardiomyopathy （ARVC）. Methods Forty-three patients [ 33 men, aged （40.4 ± 13.9）years] meet the ISFC/ESC diagnostic criteria for ARVC were enrolled in this study. A standard twelve-lead electrocardiogram was obtained during the resting status. Characteristics of fQRS were detailedly studied by three doctors independently. A comparison of the prevalence among fQRS, epsilon wave and T wave inversion （TWI）in the right precordial leads exceeding V3 was done. Results Most fQRS could be found in the inferior leads （44. 3% ）and the fight precordial leads （24. 2% ）. Within the QRS complex, the prevalence of fQRS in the R wave was significantly higher than it in the S wave（58.4% vs 32. 9% ,Z =4. 30,P 〈0. 01 ）. fQRS could be found in a total of 31 of 43 cases （mean 4. 6 ± 1.7 （range 2 to 9 ）per patient）. The prevalence of fQRS was significantly higher than that of epsilon wave （ 73.8% vs 30. 2%, Z = 3.67, P 〈 0. 01 ） and TWI （73.8% vs 41.9% ,Z =2. 61 ,P 〈0. 01 ）. Conclusion fQRS was a common electrocardiographic abnormality, and most was found in the inferior and right precardial leads in patients with ARVC. It may be used as an im- portant noninvasive preliminary screening electrocardiographic criteria.

关 键 词：致心律失常性右心室心肌病 碎裂QRS波 诊断 

分 类 号：R542.2[医药卫生—心血管疾病]