肥厚型心肌病患者标准12导联体表心电图J点抬高的发生率及分布特点  

The prevalence and distribution of J-point elevation on routine 12-lead electrocardiograms in patients with hypertrophic cardiomyopathy

作　　者：李艳兵[1] 毛俊[2] 闫倩[1] 刘霄燕[3] 谭琛[4] 田颖[1] 王吉云[5] 吴永全[6] 曾玉杰[7] 楚建民[3] 马长生[2] 刘兴鹏[1] 张建军[1] 杨新春[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020 [2]首都医科大学附属北京安贞医院 [3]阜外心血管病医院 [4]北京军区总医院 [5]首都医科大学附属北京同仁医院 [6]首都医科大学附属北京友谊医院 [7]中日友好医院

出　　处：《中国心脏起搏与心电生理杂志》2014年第3期219-222,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的 评价肥厚型心肌病（HCM）患者标准12导联体表心电图（ECG）J点抬高（J波）的发生率及分布特点。方法 由北京7家三级甲等医院入选345例HCM患者为HCM组,根据有无J波又分为J波组与非J波组。对照组按照1∶2比例入选年龄及性别相匹配的690例健康者。采集所有入选者静息标准12导联体表心电图。J波定义为在下壁（Ⅱ、Ⅲ和aVF）、侧壁（V4-V6导联）或高侧壁（Ⅰ和aVL）连续2个及以上导联出现J点较基线抬高≥0.1 mV。J波的分布分为：①局部,J波在下壁、侧壁或高侧壁任一区域的相应导联出现;②多区域,在下壁、侧壁或高侧壁任意两个区域的相应导联出现;③普遍存在,在下壁、侧壁和高侧壁均有J波。结果 健康对照人群J波检出率为7.1%（49/690）,HCM组J波检出率为11.6%（40/345）（P=0.043）。J波主要呈局部分布,HCM组高侧壁导联J波的发生率高于健康对照组（1.7%vs 0.3%,P=0.019）。结论 HCM患者J波发生率显著高于健康对照人群;HCM患者高侧壁导联J波的发生率显著高于健康对照人群。Objective To determine the prevalence and distribution of J-point elevation on routine 12-lead electrocardiograms in patients with hypertrophic cardiomyopathy （HCM）. Method Consecutive 345 patients [ Male： 78% ; age： （49.9±10.7 ） years ] were enrolled in 7 tertiary hospitals in Beijing. The control group consisted of 690 healthy individuals matched age, sex and ethnic profile with HCM group. Resting 12-lead electrocardiograms were analyzed. J-point elevation was defined as i〉0. lmV from baseline present in 2 or more of the inferior （Ⅱ ,Ⅲ and aVF） , lateral （ V4 to V6 ） or high lateral （Ⅰ and aVL） leads. Distributions of J waves were divided into：（1）mono-regional waves which only occur at any one region of the inferior wails, lateral walls or high lateral walls ; （2）multi-regional waves which occur in any two regions of inferior walls, lateral walls or high lateral walls; （3）global waves which can be detected all of the three regions. Results The prevalence of J-point elevation was 11.6% （40/345） in HCM group and 7.1% （49/690） in control group （P = 0. 043 ）. The prevalence of J-point elevation in high lateral leads in HCM group was more than control group （1.7% vs 0.3%, P=0. 019）. Conclusions HCM patients demonstrate high .incidence of J wave than healthy individuals , and J wave in high lateral leads is more prevalent in HCM patients.

关 键 词：心血管病学 肥厚型心肌病 心电图 J点抬高 

分 类 号：R542.2[医药卫生—心血管疾病] R540.41[医药卫生—内科学]