经食管心电图测量冠心病患者左房室间期异常特征的临床价值  

Clinical value of transesophageal electrocardiogram in measuring abnormal characteristics of left atrioventricular interval in patients with coronary heart disease

作　　者：何慧 陈秀英[1] 刘孟春[1] 孟琴 卓治萍 任海婷 He Hui;Chen Xiuying;Liu Mengchun;Meng Qin;Zhuo Zhiping;Ren Hailing(The First People's Hospital ofZiyang,Ziyang 641300,China)

机构地区：[1]四川省资阳市第一人民医院,641300

出　　处：《心脑血管病防治》2020年第6期584-586,591,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨经食管心电图测量冠心病患者左房室(AR)间期异常特征的临床价值。方法选择2017年6月至2018年12月间四川省资阳市第一人民医院收治的冠心病患者62例为研究对象,经食管心电图测量AR间期结果分为异常组(AR间期≤100 ms)和对照组(AR间期>100 ms),每组31例,比较两组患者的心电图特征、冠状动脉病变程度、心脏彩色超声情况。结果异常组患者的左心室功能指标收缩末期容量(ESV)、舒张末期容量(EDV)均大于对照组患者,而每搏量(SV)、心输出量(CO)均小于对照组患者,差异具有统计学意义(t=2.018、2.009、2.005、2.083,P <0.05);62例患者中,共45例单支冠状动脉病变,17例双支及多支冠状动脉病变。两组患者右冠状动脉病变的例数比较,差异具有统计学意义(χ2=5.833,P <0.05),而病变支数>1、左回旋支、左前降支病变例数比较,差异均无统计学意义(P> 0.05);异常组患者的心脏超声参数中,16心肌节段自QRS波起点至最大收缩容积时间的标准校正差值(Tmsv 16-Dif%)、16心肌节段自QRS波起点至最大收缩容积时间的最小校正差值(Tmsv 16-SD%)、左心房内径均大于对照组患者,差异均具有统计学意义(t=2.301、2.328、2.426,P <0.05),而异常组患者的二尖瓣口早期舒张血流速E峰与晚期舒张血流速A峰的比值(E/A)、左心室射血分数(LVEF)均大于对照组患者,但差异均无统计学意义(P> 0.05)。结论经食管心电图显示,冠心病患者AR间期异常的主要特征表现为左心室功能异常及左心房增大,且病变部位多为右冠状动脉,早期识别及干预治疗有益于冠心病患者。Objective To investigate the clinical value of transesophageal electrocardiogram(TEE) in measuring the abnormal characteristics of left atrioventricular(AR) interval in patients with coronary heart disease(CHD). Methods 62 patients with coronary heart disease admitted to the first people’s Hospital of Ziyang City from June 2017 to December 2018 were selected as the study objects. Patients were divided into abnormal group(AR interval ≤ 100 ms) and control group(AR interval > 100 ms) according to the results of left AR interval measured by TEE. Each group has 31 patients. ECG characteristics, the severity of coronary artery lesions and echocardiographic features in the two groups were compared. Results The left ventricular function indexes such as end-systolic volume(ESV) and end-diastolic volume(EDV) in abnormal group were higher than those of control group, while stroke volume(SV) and cardiac output(CO) were less than those in control group, the differences were statistically significant(t=2.018, 2.009, 2.005, 2.083, P < 0.05). Of the 62 patients, there were 45 cases of single coronary artery disease and 17 cases of double and multiple coronary artery disease. There was statistically significant difference of the number of cases of right coronary artery disease between the two groups(χ~2=5.833, P < 0.05). There was no statistically significant difference in the numbers of diseased branches > 1, left circumflex branch and left anterior descending branch lesions between the two groups(P > 0.05). In the abnormal ultrasound parameters of patients in the abnormal group, the standard corrected difference(Tmsv 16-Dif%) and the minimum corrected difference(Tmsv 16-SD%) of the 16 myocardial segments from the start of the QRS wave to the maximum systolic volume time and the left atrium inner diameter were greater than those in the control group, and the differences were statistically significant(t=2.301, 2.328, 2.426;P < 0.05), but the ratio of E peak of the early diastolic blood flow to the A peak of late diastolic b

关 键 词：冠心病 左房室间期异常 经食管心电图 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]