室性心律失常住院患者的横断面调查  

Cross-sectional survey on ventricular arrhythmias in a department of cardiology

作　　者：魏薇[1] 薛玉梅[1] 詹贤章[1] 方咸宏[1] 廖洪涛[1] 邓海[1] 梁远红[1] 廖自立[1] 刘洋[1] 刘方舟[1] 林炜东 吴书林[1] 

机构地区：[1]广东省心血管病研究所广东省人民医院心内科广东省医学科学院,广州510080

出　　处：《中华心律失常学杂志》2017年第3期242-245,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：广东省公益研究与能力建设基金（20148070705005）

摘　　要：目的调查体表心电图的快速室性心律失常（VA）的特征和分布情况。方法2013年1月1日至2014年12月31日广东省人民医院心内科筛查12导联体表心电图有VA的患者，测量基线QRS时限（QRS-B）及室性心律失常QRS时限（QRS-VA），分析起源，并按6种基础心脏病（冠心病、非缺血性心肌病、先天性心脏病、瓣膜性心脏病、非器质性心脏病、其他）及3个年龄段进行总结。结果同期心内科住院患者共19554例，体表心电图VA检出率为4．9％，起源于流出道的占比51．7％。非器质性心脏病组的QRS-B明显大于冠心病组、非缺血性心肌病组、先天性心脏病组和瓣膜性心脏病组（P〈0．01）；除冠心病组外，非器羼胜心脏病组的QRS-VA明显小于其他各组（P〈0．05）。非缺血性心肌病组的QRS-VA／QRS-B比值小于其他各组（P〈0．05）。各疾病组的VA的起源部位差异有统计学意义（P〈0．001），器质性心脏病较非器质性心脏病的VA分布于非流出道的比例大。3个年龄段的基础心脏病和VA分布差异有统计学意义（P〈0．001），年龄越大VA越可能分布在双心室的非流出道。结论该时期心内科住院患者的VA起源于流出道的占比最大。非器质性心脏病患者的QRS．B和QRS．VA小于器质性心脏病患者，且VA起源于流出道的占比大于器质性心脏病患者。非缺血性心肌病组的QRS-VA／QRS-B比值小于其他各组。Objective We intended to study the characteristics and distributions of fast ventricular ar- rhythmias （VA） demonstrated by surface electrocardiograms（ECG） of inpatients that had been hospitalized by the Department of Cardiology of Guangdong General Hospital from Jan 1,2013 to Dee 31,2014. Methods We recorded the quantity and types of fast VA,measured QRS duration of VA（QRS-VA） and baseline QRS dura- tions （QRS-B） , analyzed their origins according to related cardiac diseases and 3 age groups. Results A total of 19 554 patients were screened. Prevalence of VA was 4.9%. Among these VA ,51.7% originated from ven- tricular outflow tract （VOT）. The QRS-B of non-structural heart diseases was narrower than those of coronary artery diseases, non-ischemic myocardiopathy, congenital heart diseases and valvular diseases （all P values 〈 0. fll ）. The QRS-VA of non-structural heart diseases was narrower than those of other groups except for coro- nary artery diseases/isehemic myoeardiopathy （ all P values 〈 0.05 ）. QRS-VA/QRS-B ratio of non-ischemic myoeardiopathy was smaller than that of other groups （ all P values〈0. 05 ）. The VA origins of different heart dis- eases were significantly different （ P〈0. 001 ）. The VAs of structural heart diseases were more like originating from non-VOT sites. The baseline heart diseases and VA distributions in the 3 age groups were significantly different （P〈0. 001 ）. The older the patient was, the more likely the VAs＇ were to be distributed in an on-VOT sites. Conclusions The majority of VAs of our inpatients during these 2 years originated from VOT. The QRS-B of non-structural heart diseases were narrower than those of structural heart diseases. The percentage of VA origins from VOT was higher in non-structural heart diseases than those in structural heart diseases. QRS-VA/QRS-B ratio of non-ischemic heart diseases was smaller than that of other groups.

关 键 词：横断面调查 体表心电图 室性心律失常 

分 类 号：R541.7[医药卫生—心血管疾病]