完全性右束支传导阻滞与右心房增大的相关性研究  

Correlation between complete right bundle branch block and right atrial enlargement

作　　者：张付涛 赵丹清 刘晓洁 吴金涛[2] 张雷明[2] 胡娟[2] 范宪伟[2] 杨海涛[2] 严丽洁[2] 刘静静[2] 张智文 王山岭[2] ZHANG Fu-tao;ZHAO Dan-qing;LIU Xiao-jie;WU Jin-tao;ZHANG Lei-ming;HU Juan;FAN Xian-wei;YANG Hai-tao;YAN Li-jie;LIU Jing-jing;ZHANG Zhi-wen;WANG Shan-ling(Department of Cardiology,Henan University People’s Hospital,Henan Provincial People’s Hospital,Zhengzhou 450003,China;Arrhyth Center,Heart Centre of Henan Provincial People’s Hospital,Central China Fuwai Hospital,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南大学人民医院,河南省人民医院心内科,河南省郑州市450003 [2]河南省人民医院心脏中心,华中阜外医院,郑州大学华中阜外医院心律失常中心

出　　处：《中国心血管病研究》2022年第8期711-714,共4页Chinese Journal of Cardiovascular Research

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ202002030);河南省科技攻关项目(212102310793);河南省医学科技攻关计划联合共建项目(2018020447)。

摘　　要：目的探讨完全性右束支传导阻滞(complete right bundle branch block,CRBBB)与右心房增大的相关性。方法回顾分析2018年3月1日至3月31日我院住院诊疗的2394例患者的心电图记录,CRBBB定义为心电图QRS波持续时间≥120 ms,I、V_(6)导联S波时限>R波时限,V_(1)和(或)V_(2)导联QRS波群呈RsR’,R’>R。比较CRBBB与非CRBBB患者的临床资料,并采用单因素及多因素logistic回归分析,评估CRBBB的相关危险因素。结果CRBBB患病率为1.5%(37/2394)。与无CRBBB患者相比,CRBBB患者的年龄及左、右心房直径更大,心房颤动及瓣膜病的发病率更高。多因素logistic回归分析显示,右心房增大(OR=10.537,95%CI 5.332~20.821,P<0.001),年龄(OR=1.031,95%CI 1.005~1.058;P=0.019)、心房颤动(OR=3.251;95%CI 1.402~7.541;P=0.006)是CRBBB存在的独立相关因素。结论在本研究人群中,CRBBB与右心房增大存在相关性。Objective To investigate the correlation between complete right bundle branch block and right atrial enlargement.Methods Database of ECG recordings of 2394 patients who were hospitalized in our hospital for diagnosis and treatment from 1st March to 31st March 2018 were retrospectively analyzed.The complete right bundle branch block,which was defined as QRS duration of more than 120 milliseconds in right precordial leads,slurred S wave(S-wave duration>R-wave duration)in leads I and V_(6),as well as RSR’pattern with R’taller than R in lead V_(1) and/or V_(2) lead.The clinical data was compared between CRBBB group and non-CRBBB group.The univariate analysis was performed using logistic regression.Variables that significantly correlated in the univariate analysis were further analyzed using a forward multiple logistic regression analysis to identify factors associated with CRBBB.Results Among the 2394 patients,CRBBB was detected in 37 patients(1.5%).Compared with patients without CRBBB,patients with CRBBB were older and had a larger left atrial diameter and right atrial diameter.The prevalence of valvular heart disease and atrial fibrillation was significantly higher in patients with CRBBB compared with those without CRBBB.In the forward multivariate logistic analysis,right atrial enlargement(OR=10.537,95%CI 5.332-20.821,P<0.001),age(OR=1.031,95%CI 1.005-1.058,P=0.019),atrial fibrillation(OR=3.251,95%CI 1.402-7.541,P=0.006)were associated with CRBBB.Conclusion CRBBB was significantly associated with right atrial enlargement in hospitalized patients with cardiovascular diseases.

关 键 词：完全性右束支传导阻滞 右心房增大 QRS波持续时间 

分 类 号：R541.7[医药卫生—心血管疾病]