心电图aVR导联初步映像判断心力衰竭的临床研究  

Clinical research on the preliminary image of aVR lead in ECG to judge cardiac failure

作　　者：张强[1] 唐春燕 艾虎[2] 唐闽 赵雪燕 奴尔巴合提 王喜萍[1] ZHANG Qiang;TANG Chunyan;AI Hu;TANG Min;ZHAO Xueyan;NUERBAHETI;WANG Xiping(Department of Cardiovascular Internal Medicine,The People’s Hospital of Shihezi City,Xinjiang,Shihezi 832002,China;Department of Cardiovascular Internal Medicine,Beijing Hospital,Beijing 100000,China;Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100000,China)

机构地区：[1]新疆石河子市人民医院心血管内科,新疆石河子832002 [2]北京医院心血管内科,北京100000 [3]中国医学科学院阜外医院,北京100000

出　　处：《中国医药科学》2023年第11期176-179,共4页China Medicine And Pharmacy

基　　金：新疆生产建设兵团财政科技计划项目(2020CB012);新疆生产建设兵团第八师石河子市财政科技计划项目(2022NY05)。

摘　　要：目的探讨aVR导联T波不同形态与心力衰竭的相关性。方法随机选取新疆石河子市人民医院心血管内科2019年1月至2020年12月住院患者,经心脏超声Simpson’s法测量心脏左心室射血分数(LVEF),LVEF%≤40%病例101例、40%<LVEF%<50%病例106例、LVEF%≥50%病例101例,并记录首次就诊时脑钠肽测量值;根据首次就诊aVR导联T波形态,分组为T波直立组、未明显偏移组及倒置组,比较研究T波形态、QTc时限与心力衰竭的相关性。结果研究发现年龄增大并患房颤、高血压及冠心病者,心力衰竭患病率明显偏高。T波直立组中,LVEF%≥50%病例有1例(1.62%);T波未明显偏移组中,LVEF%≥50%病例有53例(40.46%);T波倒置组中,LVEF%≥50%病例有16例(13.92%),其组间两两比较,差异有统计学意义(P<0.05);aVR导联T波的不同形态组间比较,T波直立组的左心房前后径大、左心室舒张末内径大、左心室舒张容积大、LVEF低、脑钠肽高、QTc时限长,差异有统计学意义(P<0.05)。LVEF降低或轻度降低的患者aVR导联QTc时限不论男性或女性人群,均与脑钠肽、右心室前后径、左心室舒张末内径、心室舒张容积成呈正相关(r为正值、P<0.05),而与EF值呈负相关(r为负值、P<0.05)。结论aVR导联T波直立、QTc时限延长,是无创早期可以初步判断心功能状态的映像参数。Objective To investigate the correlation between different forms of T wave in aVR lead and cardiac failure.Methods Inpatients admitted to the Department of Cardiovascular Internal Medicine of the People’s Hospital in Shihezi City of Xinjiang Autonomous Region from January 2019 to December 2020 were randomly selected.The left ventricular ejection fraction was measured by cardiac ultrasound Simpson’s method.There were 101 cases with LVEF%≤40%,106 cases with 40%<LVEF%<50%and 101 cases with LVEF%≥50%.And the measured value of brain natriuretic peptide at the first visit was recorded.According to the form of T wave in aVR lead at the first visit,patients were divided into the orthostatic T wave group,the T wave group without obvious deviation and the T wave inversion group.The correlation between T wave form,QTc time limit and cardiac failure was comparatively studied.Results In the research,it was found that the prevalence of cardiac failure was obviously higher in elderly patients complicated with atrial fibrillation,hypertension and coronary heart disease.In the orthostatic T wave group,there was 1 case(1.62%)with LVEF%≥50%;In the T wave group without obvious deviation,there were 53 cases(40.46%)with LVEF%≥50%;In the T wave inversion group,there were 16 cases(13.92%)with LVEF%≥50%,with statistically significant differences between every two groups(P<0.05).Upon comparison of different forms of T waves in aVR lead between the three groups,the orthostatic T wave group had larger left atrial anteroposterior diameter,larger left ventricular end diastolic diameter,larger left ventricular diastolic volume,lower left ventricular ejection fraction,higher measurement value of brain natriuretic peptide and longer QTc time limit,with statistically significant differences(P<0.05).The QTc time limit in aVR lead of patients with decreased or slightly decreased left ventricular ejection fraction was positively correlated with the measurement value of brain natriuretic peptide,right ventricular size,left ventricular e

关 键 词：心电图 AVR导联 T波形态 心力衰竭 

分 类 号：R540.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]