摘要
目的探讨肥厚型心肌病住院患者的心电图特点。方法对1994年5月～2005年7月北京大学人民医院和北京世纪坛医院收治的经超声心动图诊断为肥厚型心肌病的住院患者76例,分析其心电图特点。结果按肥厚的部位分为单纯室间隔肥厚或室间隔肥厚为主组(46例)、单纯心尖肥厚组(14例)、单纯游离壁肥厚组(6例)和弥漫性肥厚组(10例)。间隔肥厚为主组患者中,23例(50.0%)存在病理性Q波,其中间隔厚度超过2.0cm者10例(42.5%);而在另23例无病理性Q波患者,间隔厚度超过2.0cm者仅5例(21.7%)。心尖肥厚组和单纯游离壁肥厚组均仅1例心电图存在病理性Q波。QRS波群宽度在各组无显著性差异(p>0.05)。76例患者中,心电图符合左室肥厚(SV1+RV5≥4.0mV)诊断标准的23例(30.3%),符合RV4>RV5>RV6(或RV3>RV4>RV5)者34例(44.7%),ST-T改变共71例(93.4%),ST段下移超过0.1mV者53例(69.7%),T波深倒置振幅超过0.5mV者30例(39.5%)。T波深倒置在心尖肥厚组多于间隔肥厚组(P=0.02),但T波倒置深度与心尖肥厚程度无明显相关(p=0.40)。间隔肥厚为主组中梗阻型和非梗阻型各项心电图指标无显著性差异(p>0.05)。结论病理性Q波多出现在室间隔肥厚为主型患者,T波深倒置在心尖肥厚组多于间隔肥厚组,但T波倒置深度与心尖肥厚程度无明显相关。
Objective The purpose of this study is to analyze electrocardiogram characteristics of hypertrophic eardiomyopathy. Methods Seventy-six in-patients with hypertrophic eardiomyopathy （HCM） were enrolled. The diagnosis of HCM was based on 2-dimensional eehocardiography. The 12 leads electrocardiogram characteristics were analyzed comparing with echocardiography. Results These patients were divided into four groups by echocardiography： the sole or main septal hypertrophy （46 eases）, single apical hypertrophy （14 cases）, single LV free wall hypertrophy （6 eases） and global hypertrophy （10 eases）. Twenty-three eases of septal hypertrophy （50%） had pathological Q waves and the maximum ventficular wall thickness exceeded 2.0cm （42.5%） in ten of them. In addition, there were only 5 eases （21.7%） that the maximum ventrieular wall thickness exceeded 2.0era in those who had no pathological Q waves （p=0.116）. Septal hypertrophy group and single LV free wall hypertrophy group both had only 1 ease with pathological Q wave. There is no significant difference in width of QRS complex among four groups （p〉0.05）. Among 76 eases, appearance of Sv1＋Rv5 ≥4.0mV seen in 23eases （30.3%）, Rv4〉Rv6〉Rv6（or Rv3〉Rv4〉Rv5） in 34（44.7%）, ST segment and T wave changes 71 cases（93.4%）, Giant negative T waves exceeding 0.SmV 30eases （39.5%）, while there is no significant relationship between the depth of negative T wave and the maximum apical thickness （p=0.40）, There were no difference in clinic characteristics and parameters of electrocardiogram between the group of LV outflow obstruction and no obstruction in septal hypertrophy group. Conclusion Pathological Q wave usually was seen in septal hypertrophy group , and deep negative T waves were much common in apical hypertrophy group but there is no significant relationship with the maximum apical thickness.
出处
《临床心电学杂志》
2007年第4期253-255,共3页
Journal of Clinical Electrocardiology
关键词
肥厚型心肌病
超声心动图
心电图
hypertrophic cardiomyopathy
echocardiography
electrocardiogram
