心电图左室肥厚的流行病学及心电图特征分析  

Analysis of the epidemiology and electrocardiographic characteristics of left ventricular hypertrophy in the electrocardiogram

作　　者：张炜岱 周琳洁 郭海森[1] 倪楚民[1] 章佳伟 蔡志雄[1] 陈宋明[2] ZHANG Weidai;ZHOU Linjie;GUO Haisen;NI Chumin;ZHANG Jiawei;CAI Zhixiong;CHEN Songming(Department of Cardiology,Shantou Central Hospital,Shantou 515041,China;Department of Cardiology,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头市中心医院心血管内科,广东汕头515041 [2]汕头大学医学院第一附属医院心血儈内科,广东汕头515041

出　　处：《汕头大学医学院学报》2021年第4期200-204,共5页Journal of Shantou University Medical College

基　　金：广东省医学科学技术研究基金(A2019219);广东省科技创新战略专项资金项目(纵向协同管理方向)(2018-157-42);汕头市医疗卫生科技计划项目(汕府科[2019]106号-20)。

摘　　要：目的:探讨心电图左室肥厚的流行病学特征和左室肥厚伴继发性ST-T改变的心电图特征,从而提供可用于鉴别诊断的信息,以减少误诊。方法:回顾性收集2015年7月—2017年6月汕头大学医学院第一附属医院的住院及门急诊患者的心电图,根据Sokolow-Lyon标准筛选左室肥厚心电图,分析心电图左室肥厚的发生率、性别、年龄、ST-T异常比例等流行病学特征。序贯收集2015年7—12月汕头大学医学院第一附属医院住院患者的心电图等临床资料,筛选左室肥厚伴继发性ST段抬高的病例,分析其临床资料及心电图特征。结果:共收集心电图55308份,其中心电图左室肥厚共3798例,占总数的6.87%;与非左室肥厚组相比,左室肥厚组的男性比例、年龄、ST-T异常比例更高,差异均有统计学意义(均P<0.05)。收集和分析60例左室肥厚伴继发性ST段抬高的心电图,发现2个相邻导联同时达到ST段抬高型心肌梗死指南规定的ST段抬高阈值的心电图有24例,占总数的40%。抬高的导联主要集中在前间壁导联(V1、V2和V3),V1和V2导联的S波振幅与其ST段抬高幅度均呈正相关(r=0.671,P<0.01;r=0.338,P<0.01)。结论:医院就诊人群出现心电图左室肥厚的比例较高。心电图左室肥厚所致的继发性ST段抬高可能导致误诊为心肌梗死,需要引起重视。Objective:To investigate the epidemiological characteristics of electrocardiogram(ECG)left ventricular hypertrophy and ECG characteristics of left ventricular hypertrophy with secondary ST-T changes so as to provide information that can be used for differential diagnosis to reduce misdiagnosis.Methods:ECGs of inpatients and outpatients from the First Affiliated Hospital of Shantou University Medical College were retrospectively collected from July 2015 to June 2017,and left ventricular hypertrophy ECGs were screened according to the Sokolow-Lyon criteria,and epidemiological characteristics such as the incidence of left ventricular hypertrophy on ECG,gender,age,and the proportion of ST-T abnormalities were analyzed.The ECG and clinical data of patients hospitalized in the First Affiliated Hospital of Shantou University Medical College were collected sequentially from July to December 2015,and cases of left ventricular hypertrophy with secondary ST-segment elevation were screened,and their clinical data and ECG characteristics were analyzed.Results:A total of 55308 ECGs were collected,among which a total of 3798 cases of ECG left ventricular hypertrophy were found,accounting for 6.87% of the total;compared with the non-left ventricular hypertrophy group,the proportion of males,age,and ST-T abnormalities were higher in the left ventricular hypertrophy group,and the differences were statistically significant(all P<0.05).60 ECGs of left ventricular hypertrophy with secondary ST-segment elevation were collected and analyzed,and 24 ECG cases(40% of the total)were found in which 2 adjacent leads simultaneously reached the threshold of ST-segment elevation prescribed by the guidelines for ST-segment elevation myocardial infarction.The elevated leads were mainly concentrated in the anterior interventricular leads(V1,V2,and V3),and the S-wave amplitudes in both V1 and V2 leads were positively correlated with their ST-segment elevation amplitudes(r=0.671,P<0.01;r=0.338,P<0.01).Conclusion:The proportion of patients with left

关 键 词：心电图 左室肥厚 流行病学 ST段抬高 急性胸痛 

分 类 号：R540.4[医药卫生—心血管疾病]