a VR导联T波直立在心血管疾病中的应用价值  

Analysis of a VR lead T-wave upright in cardiovascular disease

作　　者：李泽龙 邹敏 郭慧 苏慧英 罗光辉 Li zelong;Zou min;Guo hui;Su huiying;Luo guanghui(Cardiovascular Department of Anxiang County People's Hospital,Hunan,Changde,415600,China)

机构地区：[1]湖南省常德市安乡县人民医院,415600

出　　处：《临床心电学杂志》2024年第5期335-339,共5页Journal of Clinical Electrocardiology

基　　金：湖南省卫生经济与信息学会一般资助项目(编号:2022D03)。

摘　　要：目的探索aVR导联T波直立在心血管疾病中的诊治意义。方法系统收集本院2023年1月至11月所有心电图呈现aVR导联T波直立患者的临床资料,分析T波直立与临床诊断的关系。结果共纳入29例患者,平均年龄(66.8±10.1)岁,其中男性44.8%(13/29),女性55.2%(16/32),临床症状多表现为呼吸困难51.7%(15/29)、胸部不适20.7%(6/29)、心悸13.8%(4/29)、头晕6.9%(2/29)、意识丧失6.9%(2/29),62.1%(18/29)合并高血压,17.5%(5/29)合并糖尿病,24.1%(7/29)合并高脂血症,13.8%(4/29)合并房性心律失常(其中房扑1例,房颤3例),3.5%(1/29)合并室性心动过速。所有患者100%(29/29)心电图均出现ST-T改变6.9%(2/29)T波呈双拱形,均为心尖肥厚型心肌病患者;13.8%(4/29)V4、V5、V6导联ST段呈穹隆样,超声心动图均提示左心室室壁瘤;17.2%(5/29)出现QT间期延长,其中2例为应激性心肌病,3例为脑血管意外。约55.2%T波直立患者诊断肥厚型心肌病(16/29),20.7%诊断为左心室室壁瘤(6/29),6.9%诊断高血压心脏病(2/29),10.3%诊断脑血管意外(3/29),6.9%诊断应激性心肌病(2/29);结论心电图aVR导联T波直立对心血管疾病具有较好的预测价值,值得临床重视。Objective To explore the prognosis value of upright T-wave on lead aVR in the diagnosis of cardiovascular diseases.Methods Clinical data of all patients with upright T-wave on lead aVR in our hospital from January to November 2023 were systematically collected,and the relationship between the upright T-wave and clinical diagnosis was analyzed.Results A total of 29 patients were included,with an average age of(66.8±10.1)years.About 44.8%(13/29)were male,55.2%(16/32)were female.The main complaints of clinical symptoms were dyspnea 51.7%(15/29),chest discomfort 20.7%(6/29),palpitation 13.8%(4/29),dizziness 6.9%(2/29)and loss of consciousness 6.9%(2/29).There were 62.1%(18/29)patients with hypertension,17.5%(5/29)patients with diabetes,24.1%(7/29)patients with hyperlipidemia,13.8%(4/29)patients with atrial arrhythmia,including 1 case of atrial flutter and 3 cases of atrial fibrillation,3.5%(1/29)patients with ventricular tachycardia.ST-T changes were found in all 29 patients,and T-wave double arch changes were found in 6.9%(2/29)of patients,all of which were patients with apical hypertrophic cardiomyopathy.About 13.8%(4/29)showed dome-like ST segment changes in leads V4/V5/V6,and echocardiography showed left ventricular aneurysm.QT interval prolongation occurred in 17.2%(5/29),including 2 patients with stress cardiomyopathy and 3 patients with cerebrovascular accident.55.2%(16/29)patients were diagnosed with hypertrophic cardiomyopathy,20.7%(6/29)with left ventricular aneurysm,6.9%(2/29)with hypertensive heart disease,10.3%(3/29)with cerebrovascular accident,and 6.9%(2/29)with stress cardiomyopathy.Conclusions Upright T-wave on Lead aVR is a predictor of cardiovascular disease.

关 键 词：AVR导联 T波直立 心血管疾病 

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