心电图筛查继发孔型房间隔缺损的应用价值  

Electrocardiogram parameter characteristics in the screening of ostium secundum defect

作　　者：张梦云 李京秀 王延林 狄欣欣 王慕秋 高敏[1] Zhang Mengyun;Li Jingxiu;Wang Yanlin;Di Xinxin;Wang Muqiu;Gao Min(Department of Electrocardiogram,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)心电科,合肥230001

出　　处：《中国临床保健杂志》2023年第5期688-691,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨体表心电图胸导联的形态改变在筛查继发孔型房间隔缺损中的应用价值。方法回顾性分析2020年1月至2022年12月中国科学技术大学附属第一医院(安徽省立医院)心脏外科术后诊断为继发孔型房间隔缺损的113例患者作为研究组,79例诊断为室间隔缺损患者作为对照组,比较2组术前体表心电图胸导联特点,并分析研究组患者体表心电图胸导联改变与性别、年龄、房间隔缺损长径及右心室横径的关系。结果研究组113例患者中41例(36.3%)V1呈右束支传导阻滞图形或四相波伴胸导联中出现至少1个QRS波有切迹或顿挫;对照组79例患者中3例(3.8%)有上述阳性现象;研究组心电图胸导联出现上述阳性现象比率高于对照组,差异有统计学意义(χ^(2)=277.89,P<0.05);研究组不同性别者上述阳性现象发生率差异无统计学意义(χ^(2)=0.75,P=0.39);多因素logistic回归分析发现年龄及右室横径大小并非上述阳性征象的独立危险因素(P>0.05);房间隔缺损长径是其发生的独立危险因素(P<0.05)。结论体表心电图V1导联呈右束支传导阻滞图形或四相波伴胸导联切迹或顿挫是筛查继发孔型房间隔缺损的一项有价值的指标,房间隔缺损长径是其独立危险因素。Objective To explore the morphological changes of ECG chest leads in patients with ostium secundum defect.Methods We analyzed 113 patients with ostium secundum defect and 79 patients with ventricular septum defect between January 2020 to December 2022.The characteristics of chest leads of body surface electrocardiogram before the operation were analyzed.The relationship between the electrocardiogram parameter characteristic in chest leads and age,gender,defect length,and right ventricular transverse diameter in patients with ostium secundum defect.Results Of 113 cases of ostium secundum defect,41 cases(36.3%)showed right branch block or four-phase block.At least one QRS wave with a notch or collapse in the chest leads:3 cases(3.8%)in the ventricular septum defect group.The positive rate of ECG chest leads in the ostium secundum defect group was higher than that in the ventricular septum defect group.There was a difference in the lesion group(χ^(2)=277.89,P<0.05).There was no significant difference in the incidence of gender in the study group(χ^(2)=0.75,P=0.39).Multivariate logistic regression showed that there was no correlation between age and right ventricular transverse diameter(P>0.05).There was a positive correlation between the diameter of the ostium secundum defect and occurrence and statistical significance(P<0.05).Conclusions The pattern of the right bundle branch block or four-phase wave with the notch in lead V1 is a valuable pattern in the screening of ostium secundum defect,which is positively correlated with the diameter of the atrial septum defect.

关 键 词：房间隔缺损 心电描记术 诊断技术 心血管 危险因素 

分 类 号：R54[医药卫生—心血管疾病]