论文部分内容阅读
目的探讨完全性左束支阻滞(CLBBB)患者心电图I导联QRS波呈宽“M”型在评估左室功能及临床危险程度方面的作用。方法心电图检出CLBBB患者I导联QRS波呈宽“M”型20例为“M”型组,随机选择41例I导联无“M”型的CLBBB患者作为对照组,经心脏超声检测左室舒张期末内径、左室收缩期末内径、左室射血分数、左室心肌节段性运动,对照分析左室功能状况。结果①“M”型组100%出现左室扩大,其中8例全心扩大,对照组左室扩大11例占26.83%;②“M”型组19例(19/20)患者出现左室室壁整体运动减低,占95%,对照组7例,如果包括局部运动减低共18例(18/41),占43.90%;③“M”型组20例患者的射血分数均低于40%,对照组仅5例;④“M”型组20例患者左室收缩期末内径均>37mm,对照组12例;⑤“M”型组20例患者的左室舒张期末内径均>56mm,对照组11例。两组间各种指数对照结果x2检验,差异显著(p<0.05)。结论发生在慢性心力衰竭并CLBBB患者的心电图I导联QRS波呈宽“M”型与患者左室扩大、左室泵功能明显降低密切相关;如果CLBBB患者出现I导联QRS波呈宽“M”型,提示其心衰严重,危险程度增加,预后较差。
Objective To investigate the role of QRS wave of lead Ⅰ in patients with complete left bundle branch block (CLBBB) presenting a wide “M” shape in assessing left ventricular function and clinical risk. Methods The QRS waves of I lead from CLBBB were detected in 20 cases of “M” type in the “M” group and 41 cases of CLBBB in the I lead without “M” type as the control group Left ventricular diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left ventricular myocardial segmental motion were measured by echocardiography, and left ventricular function was analyzed. Results ① The left ventricular enlargement was found in 100% of the “M” group, of which 8 cases were enlarged in the whole heart, while the control group had enlarged left ventricle in 11 cases (26.83%). In the “M” group, 19 cases There was a decrease of 95% in left ventricular wall motion, 7 in control group and 18 cases in 18 cases (18/41), including 43.90% in local control group. Ejection ejection of 20 patients in “M” group The scores were lower than 40% in the control group and only 5 cases in the control group. The mean diameter of the left ventricular systolic dimension in the “M” group was> 37mm at the end of the experiment, 12 in the control group, and 20 in the “M” Left ventricular end diastolic diameter were> 56mm, control group, 11 cases. The two groups between the various index control results x2 test, the difference was significant (p <0.05). Conclusions The QRS wave of lead I of ECG in patients with chronic heart failure and CLBBB is wide and the type of “M” is closely related to the enlargement of left ventricular and left ventricular function in patients with CLBBB. If the QRS wave of lead I appears to be wide “M ” type, suggesting that severe heart failure, increased risk, the prognosis is poor.