48例异常宽大T波心电图的临床意义分析  

Analysis of the clinical significance of abnormally wide T waves in electrocardiogram in 48 cases

作　　者：韦卫中[1] 徐春芳[2] 王铁锚[2] 杨晓云[2] 左萍[2] 黄芬[2] 林凡[2] 

机构地区：[1]武汉市儿童医院 [2]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2013年第5期275-277,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨异常宽大T波的疾病谱、产生机制和临床意义。方法:分析86 007例住院患者的12导联心电图,从中筛选出心电图T波时间>250 ms并且形态异常宽大的48例,统计其疾病谱以及肌钙蛋白、心肌酶谱、NT-proBNP、D-二聚体、电解质、血红蛋白、超声心动图等相关指标。结果:异常宽大T波的发生率为0.05%。疾病谱显示:脑血管意外、严重感染、肺血栓栓塞、多器官功能衰竭等疾病占79%,女性多于男性,脑血管意外组中宽大直立T波与宽大倒置T波发生例数相似。结论:异常宽大T波可见于多种重症疾病;交感神经兴奋性异常增高,儿茶酚胺性心肌损害可能是发生宽大T波的主要机制;宽大直立T波与宽大倒置T波具有同等的临床意义。Objective：To investigate the disease spectrum,mechanism and clinical significance of abnormally wide T waves in ECG.Methods：The 12-lead ECG of 86 007 inpatients were analyzed,and 48 cases with T wave time greater than 250 ms and with morphologically abnormally wide were screened out,and its disease spectrum,myocardial enzymes,NT-proBNP,D-dimers,electrolytes,hemoglobin,echocardiography were observed.Results：The incidence of abnormally wide T waves is 0.05％.The disease spectrum showed that cerebrovascular accident,severe infection,pulmonary embolism,multiple organ failure accounted for 79％.The abnormally wide T waves appeared more in women than in men.The cases with upright T waves were similar with the cases with the inverted T waves in group of cerebrovascular accident.Conclusions：The abnormally wide T waves may appear in several severe diseases.Abnormal sympathetic excitability and catecholamine myocardial damage may be the main mechanism.The wide upright T waves have the same clinical significance with that of the wide inverted T waves.

关 键 词：宽大T波 疾病谱 儿茶酚胺 

分 类 号：R540.41[医药卫生—心血管疾病]