左束支阻滞合并电轴左偏临床意义的探讨  

Clinical importance of complete left bundle branch block with left QRS axis deviation

作　　者：易军[1] 王莉[1] 卢喜烈[1] 

机构地区：[1]解放军总医院心内科,北京100853

出　　处：《军医进修学院学报》2003年第1期71-77,共7页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的 :了解完全性左束支阻滞合并电轴左偏的临床诊断意义。方法 :观察了 1992年以来我院诊断为完全性左束支阻滞的 5 6名住院患者的心电图及其它相关检查 ,评估其心脏病变程度。结果 :完全性左束支阻滞合并电轴左偏患者共 2 3例 ,其中 9例原有左前分支阻滞 ,8例为先完全性左束支阻滞后逐渐合并电轴左偏 ,6例入院即为完左合并电轴左偏。其高血压、糖尿病平均病程明显长于单纯完左组 ,三尖瓣病变 ,主动脉瓣病变 (特别是主动脉瓣返流 ) ,心室扩大等心脏的病理性改变的发生率也与单纯完全性左束支阻滞组比较有统计学差别。结论 :完全性左束支阻滞合并电轴左偏时 ,心脏病变弥漫并较严重。Objective:To elucidate the diagnostic significance of left axis deviation (LAD) in patients(pts) with chronic(>6months)left bundle branch block(LBBB) Methods:we retrospectively studied 56 pts in our hospital from 1992 The evaluation included a complete history, physical examination, chest X ray films, serial 12 lead electrocardiograms(ECG),2D echocardiograms and Doppler studies Results: 23 pts had left axis deviation(LAD)and 33 pts had normal axis without axis deviation Among LAD pts, 9 had previous left anterior fascicular block 8 pts started with LBBB without axis deviation, but later ECGs showed LBBB with LAD 6 pts showed LBBB with LAD when they took ECG examination in our hospital and there were no former ECG recorders as control Compared with normal axis pts ,the average disease period of hypertension and diabetes mellitus are much longer in LAD pts There are statistically significant difference in tricuspid valve disease and aortic disease and ventricular enlargement in LBBB with LAD compared to normals These results show that LBBB with LAD has severe organic heart disease Conclusion:These findings point towards a exact clinical significance in LBBB with LAD Under this condition, the significance of LBBB with LAD should be taken seriously in clinic practice.

关 键 词：心脏传导阻滞 心电描记术 电轴左偏 并发症 

分 类 号：R541.76[医药卫生—心血管疾病]