心电图T波振幅与儿童扩张性心肌病左室射血分数的关系  

Association of T-wave amplitude on electrocardiogram with left ventricular ejection fraction in children with dilated cardiomyopathy

作　　者：谭成 易秀英 陈颖 王双双 纪青 李芳[1] 邹润梅[1] 王玉汶 王成[1] TAN Cheng;YI Xiu-Ying;CHEN Ying;WANG Shuang-Shuang;JI Qing;LI Fang;ZOU Run-Mei;WANG Yu-Wen;WANG Cheng(Department of Pediatric Cardiovasology,Children's Medical Center,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院儿童医学中心儿童心血管专科,湖南长沙410011 [2]中南大学湘雅医学院附属株洲医院儿科,湖南株洲412000

出　　处：《中国当代儿科杂志》2020年第4期374-379,共6页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨心电图T波振幅与儿童扩张性心肌病左室射血分数(LVEF)的关系。方法回顾性分析2009年5月至2018年6月诊断为扩张性心肌病的44例儿童的临床资料。根据LVEF分为LVEF≥50%组(n=26)和LVEF<50%组(n=18),且对治疗后25例进行3~42个月(平均14±9个月)的随访。采用广东中山SR-1000A心电综合自动分析仪描记仰卧位12导联体表心电图,程序自动分析结合人工干预测量12导联心电图T波振幅。结果(1)T波振幅比较:LVEF<50%组较LVEF≥50%组Ⅱ、V4、V5、V6导联T波振幅明显降低(P<0.05)。LVEF增高组(治疗后较治疗前LVEF增加>5%)治疗后aVR、V5、V6导联T波振幅明显增高(P<0.05);LVEF不变组(治疗后较治疗前LVEF增加≤5%)治疗后aVR导联T波振幅明显降低(P<0.05)。(2)受试者工作特征曲线评价:Ⅱ、V4、V5、V6导联T波振幅对扩张性心肌病患儿LVEF<50%具有预测价值(P<0.05)。当同时出现Ⅱ导联T波振幅≤0.20 mV、V4导联T波振幅≤0.40 mV、V5导联T波振幅≤0.3 mV、V6导联T波振幅≤0.30 mV时,预测扩张性心肌病患儿LVEF<50%的灵敏度为88.2%,特异度为76.0%。结论心电图T波振幅可作为评估儿童扩张性心肌病左室收缩功能的指标。Objective To study the association of T-wave amplitude on electrocardiogram(ECG)with left ventricular ejection fraction(LVEF)in children with dilated cardiomyopathy.Methods A retrospective analysis was performed for the clinical data of 44 children who were diagnosed with dilated cardiomyopathy from May 2009 to June 2018.According to LVEF,they were divided into two groups:LVEF≥50%group(n=26)and LVEF<50%group(n=18).After treatment,25 children were followed up for 3-42 months(mean 14±9 months).The Guangdong Zhongshan SR-1000 A ECG Automatic Analyzer was used to obtain the 12-lead body surface ECG results in the supine position.T-wave amplitude on ECG was evaluated by software and manual measurement.Results Compared with the LVEF≥50%group,the LVEF<50%group had a significant reduction in the T-wave amplitude in leads II,V4,V5 and V6(P<0.05).The increased-LVEF group(an increase in LVEF>5%after treatment)had a significant increase in the T-wave amplitude in leads aVR,V5,and V6 after treatment(P<0.05),while the unchanged-LVEF group(an increase in LVEF≤5%after treatment)had a significant reduction in the T-wave amplitude in lead aVR after treatment(P<0.05).The receiver operating characteristic curve analysis showed that the T-wave amplitude in leads II,V4,V5 and V6 had a certain value in predicting LVEF<50%in children with dilated cardiomyopathy(P<0.05).A combination of T-wave amplitude of≤0.20 mV in lead II,≤0.40 mV in lead V4,and≤0.30 mV in leads V5 and V6 had a sensitivity of 88.2%and specificity of 76.0%in the predication of LVEF<50%in children with dilated cardiomyopathy.Conclusions T-wave amplitude on ECG can be used as the indexes for the evaluation of the left ventricular systolic function in children with dilated cardio myopathy.

关 键 词：扩张性心肌病 心电图 T波振幅 左室射血分数 儿童 

分 类 号：R725.4[医药卫生—儿科]