扩心病合并肺动脉高压患者心电图分析  

The analysis of R wave and S wave amplitude of chest lead electrocardiogram in primary dilated cardiomyopathy with pulmonary hypertension

作　　者：谌承志[1] 刘景艳[1] 何昕[1] 袁旭明[1] 王磊[1] 陶静华 胡要[1] 杨伶俐 徐叶平[1] Chen chengzhi;Liu jingyan;He xin;Yuan xuming;Wang lei;Tao jinghua;Hu yao;Yang lingli(Department of Cardiology of Affiliated LiuYang Hospital,Nanhua University, Liu yang,410300,P.R China)

机构地区：[1]南华大学附属浏阳医院,410300

出　　处：《临床心电学杂志》2018年第3期188-191,共4页Journal of Clinical Electrocardiology

基　　金：湖南省卫生厅项目(项目编号:C2014-046)

摘　　要：目的探讨扩心病合并肺动脉高压患者心电图胸导联R波、S波振幅。方法回顾性分析我院住院治疗的扩张型心肌病患者35例,根据右心导管参数平均动脉压(m PAP≥25mmHg)将其分为2组,测量两组患者胸导联R波、S波振幅。结果与未合并肺高压组相比,扩心病合并肺高压组R_(V1)增高[(0.34±0.50)m V:(0.17±0.16)m V,p<0.05];S_(V5)增高[(0.98±0.88)mV:(0.28±0.19)mV,p<0.01];S_(V6)增高[(0.51±0.51)mV:(0.17±0.17)mV,p<0.01];R_(V1)+S_(V5)增高[(1.38±1.21)m V:(0.45±0.22)mV,p<0.01]。S_(V5)预测扩心病合并肺动脉高压(m PAP≥25 mm Hg)的曲线下面积为0.787(95%CI 0.636-0.937,p<0.01);S_(V6)预测扩心病合并肺动脉高压的曲线下面积为0.747(95%CI 0.584-0.909,p<0.05);R_(V1)+S_(V5)预测扩心病合并肺动脉高压的曲线下面积为0.795(95%CI 0.648-0.943,p<0.01)。结论通过分析胸导联R波、S波振幅提示扩心病合并肺高压组患者心电图有右室肥大改变依据,通过右室肥大改变心电图预测扩心病是否合并肺动脉高压有一定的价值。Objective To explore the R wave and S wave amplitude of chest lead electrocardiogram in primary dilated cardiomyopathy(PDCM)with pulmonary hypertension(PH). Methods According to the definition of PH(m PAP ≥25 mm Hg), Thirty five patients with PDCM in our hospital were divided into 2 groups: PDCM with PH(n=22) and PDCM without PH(n=13). The R wave and S wave amplitude of chest lead electrocardiogram was recorded. A retrospective analysis of the ECGs was performed. Results Compared with PDCM without PH group, RV1 amplitude was higher in PDCM with PH group [(0.34 ±0.50)m V:(0.17 ±0.16)m V, p <0.05]; SV5 amplitude was higher[(0.98±0.88)m V:(0.28±0.19)m V, p<0.01]; SV6 amplitude was higher[(0.51±0.51)m V:(0.17±0.17)m V,p <0.01]; RV1+SV5 amplitude was higher [(1.38 ±1.21)m V:(0.45 ±0.22)m V, p <0.01]. The area under the receiver-operating curve for SV5 to predict m PAP ≥25 mm Hg in patients with PDCMwas 0.787(95%CI 0.636-0.937,p<0.01), The area under the receiver-operating curve for SV6 to predict m PAP ≥25 mm Hg in patients with PDCM was0.747(95%CI 0.584-0.909, p<0.05), The area under the receiver-operating curve for RV1+SV5 to predict m PAP ≥25 mm Hg in patients with PDCM was 0.795(95%CI 0.648-0.943, p<0.01). Conclusion There were have signs of right ventricular hypertrophy(RVH) in patient of PDCM with PH through analysis of R wave and S wave amplitude of chest lead electrocardiogram, ECG signs of RVH were useful for predicting PH in patients with PDCM.

关 键 词：扩张型心肌病 肺动脉高压 心电图 右室肥厚 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]