不同部位肥厚型心肌病的心电图诊断价值
Diagnostic value of electrocardiogram in different types of hypertrophic cardiomyopathy
- 临床心电学杂志 2022年第1期 页码：12-16
- 作者机构：
安徽医科大学第二附属医院
- 作者简介：
- 基金信息：
DOI：
中图分类号： R540.41;R542.2-
纸质出版：2022
- 稿件说明：
移动端阅览
张薇娜, 马兰, 方思华, 等. 不同部位肥厚型心肌病的心电图诊断价值[J]. 临床心电学杂志, 2022,(1):12-16.
Zhang weina, Ma lan, Fang sihua, et al. Diagnostic value of electrocardiogram in different types of hypertrophic cardiomyopathy[J]. 2022, (1): 12-16.
摘要
目的 以不同部位肥厚型心肌病(HCM)心电图特征作为研究方向，探讨心电图对肥厚型心肌病的诊断价值。方法 选取我院2016年1月至2021年1月收治的123例肥厚型心肌病患者，回顾性分析患者相应的超声心动图及心电图检查结果，完成相关性研究。结果 经超声心动图检查并确诊的123例患者中，根据心肌肥厚部位分为心尖肥厚组23例，分为I组(n=12)和II组(n=11)；室间隔肥厚组100例，分为III组(n=64)和IV组(n=36)。与室间隔肥厚组比较，心尖肥厚组患者心电图出现巨大倒置T波和左室高电压，差异有统计学意义(χ
2
=10.156
12.878
p
<
0.05)。巨大倒置T波出现的左胸导联与心尖部位肥厚的相关性较强。与心尖肥厚组比较，室间隔肥厚组患者心电图较易出现病理性Q波(χ
2
=5.457
p
<
0.05)，差异有统计学意义，其中以IV组最常见。结论 不同肥厚部位HCM的心电图表现不同。心尖肥厚型心肌病易表现为巨大倒置T波伴ST段下移及左室高电压。心电图前壁、侧壁或下壁导联出现深而不宽的病理性Q波，可能提示室间隔肥厚型HCM。不同部位HCM患者的心电图差异，对于HCM早期诊断及分型具有重要的价值。
Abstract
Objective To explore the diagnostic value of electrocardiogram in different hypertrophic distribution of hypertrophic cardiomyopathy（HCM）. Methods One hundred and twenty-three patients with HCM in our hospital from January 2016 to January 2021 were selected. Retrospective analysis of patients with the corresponding echocardiography and ECG results
complete the correlation study. Results According to the location of myocardial hypertrophy
123 patients were divided into apical hypertrophy group（n=23 cases）
including 2 subgroups
group I（n=12） and group II（n=11）; and interventricular septal hypertrophy group（n=100）
including group III（n=64） and IV（n=36）. There was significant difference in ECG giant negative T wave inversionand left ventricular high voltage between apical hypertrophy group and interventricular septal hypertrophy group（χ2=10.156
12.878
p<0.05）
and in left chest leads showed giant negative T wave inversion
which were strongly correlated with apical hypertrophy.Compared with apical hypertrophic cardiomyopathy
interventricular septal hypertrophic cardiomyopathy was more likely to have pathological Q wave（χ2=5.457
p<0.05）. Conclusions The electrocardiographic manifestations of HCM in different hypertrophic distribution are different. Apical hypertrophic cardiomyopathy often presents giant negative T wave inversion with ST segment depression and left ventricular high voltage
accompanied by pathological Q wave with deep but not wide leads in anterior wall
lateral wall or inferior wall
which may indicate interventricular septal hypertrophy. Combined with the difference of ECG
it has important application value for early diagnosis and classification of HCM.
关键词
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references
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