致心律失常性右心室心肌病的QRS及QT离散度研究  

QT and QRS dispersion in patients with arrhythmogenic right ventricular cardiomyopathy

作　　者：杨春梅[1] 黄峻[1] 许迪[1] 单其俊[1] 马文珠[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心血管科,210029

出　　处：《中华心律失常学杂志》2003年第1期37-42,共6页Chinese Journal of Cardiac Arrhythmias

基　　金：江苏省教委自然科学基金重点项目资助 (99KJB3 2 0 0 8)

摘　　要：目的　探讨致心律失常性右心室心肌病 (arrhythmogenicrightventricularcardiomyopathy ,ARVC)危重患者、家系中无症状患者及家系中可疑患者的QRS及QT离散度的存在规律。方法　按欧洲心脏病学会 (ESC)的诊断标准 ,选择有室性心动过速、晕厥或心脏骤停 (cardiacarrest)史的ARVC患者 2 5例为危重组 ,家系调查发现的家系中无明显症状的ARVC患者 16例为无症状组 ,家系中高度怀疑为ARVC但尚未达到诊断标准的 18例为可疑组 ,正常对照组为 14例。同步记录标准 12导联心电图。测量每个导联QRS时限 ,记录 12导联中的QRS时限最大值 (QRSm ,最长的 1个QRS值 )、QRS离散度 (QRSd ,12导联中最长的 1个QRS值减最短的 1个QRS值 )及QRS时限平均值 (QRSa)。测量每个导联QT间期 ,记录 12导联中的QT最大值 (QTm ,最长的 1个QT间期 )、QT平均值 (QTa)、QT离散度 (QTd ,导联中最长的 1个QT值减最短的 1个QT值 )、校正QTd(QTcd)及校正QTm(QTcm)。比较各组各指标的差异。结果　可疑组的年龄低于对照组、危重组与无症状组。 4组之间QRSd差异无显著性。QTd在危重组为 (6 9 6± 4 1)ms,在无症状组为 (77 3± 5 7)ms均显著高于对照组 (5 5 4±6 3)ms(P均为 0 0 0 3) ;危重组与无症状组差异无显著性。QRSm、QRSa、QTa、QTcd。Objective The aim of this study was to assess the occurrence of QT and QRS dispersion in patients with severe arrhyrhmogenic right ventricular cardiomyopathy(ARVC), asymptomatic patients, and in suspected ARVC cases from ARVC families. Methods Diagnosis of ARVC was established using the criteria of European Society of Cardiology. Twenty five patients with documented sustained ventricular arrhythmia, cardiac arrest or sudden cardiac death were considered as the 'severe' group. Sixteen patients from ARVC families formed the 'asymptomatic'group.Eighteen cases from ARVC families who were suspected with ARVC but had not sufficient evidence formed the 'suspected'group. The control group consisted of 14 healthy subjects. Twelve lead electrocardiogram was recorded simultaneously. QRS and QT were measured in every lead, and QRSm, QTm, QRSd, QTd,QRSa, QTa, QTcm and QTcd were calculated. These parameters were compared in each group. Results Patients in the 'suspected'group were significantly younger than those in the control group, 'severe'and 'asymptomatic'groups. There was no difference in QRSd among these 4 groups. QTd were significantly longer in 'severe'(69.6±4.11) ms and 'asymptomatic'groups(77.3±5.7) ms than that of the control group(55.4±6.3) ms, ( P =0.003). There was no difference between the 'severe' and 'asymptomatic'groups. Other parameters(QRSm, QRSa, QTa, QTcd, QTm,QTcm) in each group were much similar as QTd. QTd, QRSm, QRSa, QTa, QTm and QTcm in the 'suspected' group were in the middle level between those of the 'asymptomatic'/'severe' groups and those of the controls. [BHDWG9,WK140mmZQ0W]Conclusion QTd is higher in ARVC patients, however, the degree of QTd could not be used as a marker for severe ARVC. All parameters in 'suspected'group were greater than that of the control and lower than that of 'severe' and 'asymptomatic'groups, suggesting that suspected cases are in a stage of progressing but have not yet developed disease. Prolonged QRS in ARVC patients suggests the presence of ventricu

关 键 词：心律失常 右心室心肌病 心电图 QT离散度 

分 类 号：R540.41[医药卫生—心血管疾病]