肥厚型心肌病体表心电图特征  

Characteristics in electrocardiogram in patients with hypertrophic cardiomyopathy

作　　者：马志玲 邵虹 胡海霞 杨倩利 刘丽文 赵志敬 MA Zhi-ling;SHAO Hong;HU Hai-xia;YANG Qian-li;LIU Li-wen;ZHAO Zhi-jing(Department of Cardiology,Xijing Hospital;Department of preventive medicine statistics office;Department of Ultrasound,Xijing Hospital,Air Force Military Medical University,Xi＇an 710032,Shaanxi,China)

机构地区：[1]空军军医大学西京医院心脏内科,陕西西安710032 [2]空军军医大学预防医学系统计教研室,陕西西安710032 [3]空军军医大学西京医院超声医学科,陕西西安710032

出　　处：《心脏杂志》2018年第5期532-537,共6页Chinese Heart Journal

基　　金：科技部国家国际合作专项资助(2014DFA31980);国家自然科学基金项目资助(81170305;30371571;81470452);陕西省国际科技合作项目资助(2013KW33-03)

摘　　要：目的探讨肥厚型心肌病(HCM)患者体表心电图(ECG)特征。方法选取2015年5月~2017年4月期间住院治疗的HCM患者60例,同时选取本院同期查体的正常人60例,作为对照组,要求两组人员性别、年龄、体质量指数匹配。分析ECG各导联QRS波时限和R波、S波振幅,异常q波情况,QTC时限,R/S比值,ST段下移与抬高,T波低平、倒置,P波时限等指标。结果 (1)HCM组的V2、V3导联QRS波时限;Ⅱ、V4导联异常Q波比例; QTC时限; P波时限;左心室肥厚ECG诊断公式SV1+RV5/V6及(SV3+Ra VL)×QRS波时限均显著高于正常对照组。(2)HCM组的I、a VR、a VL、a VF导联QRS波时限; a VR导联Q波所占比例; I、II、III、a VL、a VF、V3、V4、V5、V6导联QRS波主波与T波方向一致性; V4、V5、V6导联R/S比值均显著低于正常对照组。结论 ECG诊断HCM首先要满足左心室肥厚的诊断标准,再结合上述ECG导联的特异性参数进行综合判断。AIM To investigate the characteristic phenotype of electrocardiogram （ECG） in patients with hypertrophic cardiomyopathy （HCM）. METHODS 60 inpatients with HCM from May 2015 to April 2017 in Xijing hospital were enrolled in the study. Another 60 patients （ gender and age and weight matched in Xijing hospital） were chosen as a control group. 12-leads body surface ECGs were analysed, including QRS duration, R wave and S wave amplitude, abnormal q wave, duration of QTC, R/S ratio, ST segment elevation and depression, T wave low and inversion, and P wave duration. RESULTS In the HCM group, QRS duration in V2 and V3 leads, abnormal Q wave proportion in II and V4 leads, QTC duration, P wave duration and ECG diagnosis of left ventricular hypertrophy were significantly greater than those in the normal control group. In the HCM group, QRS duration in I, aVR, aVL and aVF leads, and Q wave proportion in aVR leads, and QRS main wave direction consistent with T wave in I, II, III, aVL, aVF, V3, V4, V5, V6, and R/S ratio in V4, V5 and V6 leads were significantly less than those in the control group. CONCLUSION Differences in the HCM group were seen when compared to the control group. Additional differences in ECG were seen when compared to the control group. Further research is warranted to appreciate the significance of these differences.

关 键 词：心肌病 肥厚型 心电图 超声心动图 

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