心电图对肥厚型心肌病的诊断价值  

Diagnostic value of electrocardiogram to apical hypertrophic cardiomyopathy

作　　者：孙亚文[1] 胡永寸[2] 郭山岭[2] 刘刚[2] 

机构地区：[1]河南省安阳地区医院心电图室,安阳455000 [2]河南省安阳地区医院心内一科,安阳455000

出　　处：《中国循证心血管医学杂志》2017年第12期1528-1529,共2页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的通过回顾分析心尖肥厚型心肌病(AHCM)患者的12导联心电图特点,探讨其对AHCM的诊断指导价值。方法对2014年12月~2016年12月于河南省安阳地区医院心内科就诊的60例AHCM患者作为观察组,与同时期我院正常体检人群50名为对照组。行12导联心电图,进行回顾性分析,比较两组人群的心电图变化情况及有无特征性变化等。结果观察组患者心电图表现为胸导联T波倒置伴ST段下移及左室高电压表现;胸导联QRS波群时间延长,且QRS波群振幅在不同导联上变化明显,均超过正常值;在ST段分别表现为V3~V6和Ⅱ、Ⅲ、a VF下移;且有42例出现V3~V6 T波倒置。患者左胸导联R波电压增高,ST段压低,>0.05m V,T波对称性倒置,左胸导联同导联R波高度与T波倒置深度,ST段压低深度呈负相关(P<0.05),T波倒置深度与ST段压低深度呈正相关(P均<0.01)。结论心电图诊断对心尖肥厚型心肌病有辅助指导价值,对AHCM患者早期行心电图检查可提高其疾病确诊率。Objective To discuss the diagnostic value of electrocardiogram （ECG） to apical hypertrophic cardiomyopathy （AHCM） through analyzing retrospectively the characteristics of 12-lead ECG in AHCM patients. Methods AHCM patients （n=60） were chosen into observation group and meanwhile normal controls （n=50） were chosen into control group from Dec. 2014 to Dec. 2016. All groups were given examination of 12-lead ECG, and the results were retrospectively analyzed. The changes of ECG were compared between 2 groups including QRS wave group, ST-segment level and T wave shape. Results In observation group, ECG showed the inversion of chest-lead T wave with ST-segment depression and left ventricular high voltage. The time of chest-lead QRS wave group was longer and amplitude of QRS wave group had significant changes, and they all exceeded normal values. ST-segment showed depressions of V3~V6, Ⅱ, Ⅲ and aVF, and there were 42 patients with V3-V6 T wave inversion. The voltage of left chest-lead R wave increased, ST-segment depressed （〉0.05 mV）, and T wave showed symmetry inversion. The height of left chest-lead R wave was negatively correlated to depth of T wave inversion and depth of ST-segment depression （P〈0.05）. The depth of T wave inversion was positively correlated to depth of ST-segment depression （all P〈0.01）. Conclusion ECG diagnosis is important to guide AHCM diagnosis. The early ECG examination can promote confirmed diagnostic rate in AHCM patients.

关 键 词：心电图 心尖肥厚型心肌病 ST-T改变 

分 类 号：R540.41[医药卫生—心血管疾病]