代谢综合征伴早复极患者的心电图及临床特点  

Electrocardiogram and clinical features of patients with early repolarization pattern and metabolic syndrome

作　　者：颜伟[1] 朱超 朱梅[1] 李玉峰[1] 陈琪[1] Yan wei;Zhu chao;Zhu mei;Li yufeng;Chen qi(Chinese People’s Liberation Army General Hospial,100853,Beijing,China;Department of Cardiology,Bejing Friendship Hospial,Capital Medical University,Bejing.100050,China)

机构地区：[1]中国人民解放军总医院,100853 [2]首都医科大学附属北京友谊医院心内科,100050

出　　处：《临床心电学杂志》2021年第6期414-418,共5页Journal of Clinical Electrocardiology

基　　金：国自然青年基金项目(项目负责人:朱超,项目编号:82000311)。

摘　　要：目的观察代谢综合征心电图有早复极患者的心电图及临床特点。方法选择2015年10月1日至2017年10月1日在我院门诊或入院治疗的代谢综合征,无冠心病和糖尿病病史患者813例。代谢综合征的定义符合美国国家胆固醇教育计划(NCEP)标准。早复极被定义为两个连续导联(除外V_(1)-V_(3)导联),QRS波终末切迹或顿挫振幅≥0.1mV,伴或不伴ST段抬高。结果共813例患者中,心电图早复极阳性[ERP(+)]110例(13.5%),早复极阴性[ERP(-)]703例(86.5%)。患者平均年龄43.51±5.19(18-82)岁。两组患者的一般情况无显著差异。ERP(+)患者,早复极分布在下壁导联46例(41.9%),下壁和胸前导联17例(15.5%),侧壁(I、a VL)导联24例(21.8%),侧壁和胸前导联13例(11.8%),胸前(V_(4)-V_(6))导联10例(9%)。其中7例(6.4%)患者有早复极J波振幅≥0.2mV,出现在下壁导联,或下壁和胸前导联,ST段呈水平型。两组患者行24小时动态心电图检查,均未记录到多形性室速/室颤等恶性室性心律失常。结论代谢综合征患者的早复极主要分布在下壁导联、下壁和胸前导联,部分患者有ERP振幅显著改变,但未记录到恶性室性心律失常的发生。Objective To observe the Electrocardiogram (ECG) and clinical characteristics of patients with metabolic syndrome (Met S) and early repolarization pattern (ERP),who have no history of coronary heart disease and diabetes.Methods A total of 813 patients with Met S,but without a history of coronary heart disease and diabetes,admitted to our hospital from October 1,2015 to October 1,2017 were selected.The definition of Met S meets National Cholesterol Education Program (NCEP) standards.ERP is defined as QRS notching or slurring in two consecutive leads(except leads V_(1)-V_(3)),with its amplitude≥0.1mV,with or without ST segment elevation.Results A total of 813 patients with Met S were enrolled,110 (13.5%) patients had ERP[ERP(+)]on their ECG,and 703 (86.5%) patients had no ERP[ERP(-)].The average age of the patients was 43.51±5.19 (18-82) years old.There was no significant difference in the general conditions of the two groups of patients.In ERP (+) patients,46 cases (41.9%) of ERP distributed in inferior leads,17 cases (15.5%) in inferior wall and anterior precordial leads,and 24 cases (21.8%) in lateral leads (I,a VL),13cases (11.8%) in the lateral and anterior precordial leads,and 10 (9%) in the anterior precordial (V_(4)-V_(6)) leads.Among them,7 subjects (6.4%) had ERP amplitude≥0.2mV,which appeared in the inferior wall leads,or inferior wall and anterior precordial leads,with the horizontal ST segment.Both groups of patients underwent 24-hour Holter monitoring,and no polymorphic ventricular tachycardia or ventricular fibrillationwas recorded.Conclusions In patients with Met S,ERP is mainly distributed in inferior leads,inferior leads and precordial leads.Some patients have significant increase of ERP amplitude.However,the occurrence of malignant ventricular arrhythmias,has not been recorded.

关 键 词：心电图 代谢综合征 早复极图型 早复极综合征 恶性室性心律失常 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]