早期复极综合征与左心室纤维肌束关系的探讨

Study on Relationship Between Early Repolarization Syndrome and Left Ventricular Fibromuscular Bands

目的 探讨左心室纤维肌束及其特征与早期复极综合征的关系。方法 选择 30例早期复极综合征患者 (ERS组 ) ,选择 5 0例健康人 (对照组 )并对左心室纤维肌束的数目、位置以及与室间隔的夹角进行统计分析。结果 ERS组与对照组相比较左心室纤维肌束的数目构成比无显著性差异 (p>0 .0 5 ) ;两组之间左心室纤维肌束位置构成比差异有显著性意义 (P<0 .0 0 1) ,ERS组起于室间隔中部而止于左室游离壁中段的左心室纤维肌束约 5 0 % ,对照组仅 4 % ;ERS组左心室纤维肌束与室间隔的夹角显著高于对照组 (P<0 .0 1)。结论 左心室纤维肌束位置及夹角是导致早期复极综合征的独立危险因素 ,推测其原因主要与左心室纤维肌束对起止点的牵拉引起部分内膜下心肌较正常激动顺序提前复极 ,造成复极不一致有关。

Objective To investigate the relationship between early repolarization syndrome (ERS) and left ventricular fibromuscular bands(LVFB). Methods Thirty cases with ESR(ESR group) and randomized 50 healthy persons without ESR(control group) were studied.The number,position and angle of LVFB formed by endocardium of intraventricular septum(IVS) inside the left ventricle were statistically analysed in the two groups. Results There was no significant difference in the LVFB numbers between ERS group and the control group(P>0.05) ;In comparing the proportions of positions,there wes a significant difference between two groups( P<0.001).The positive rates with the position from midal IVS to midal free LV wall were 50% in ERS group while 4% in control group and the angle of LVFB with LV in ERS group was larger than that in the control group (P<0.01). Conclusions The position and the angle of LVFB were independent risk factors of ERS.The supposition may be due to pull of LVFB on the original and terminal points,which cause partial myocardium to repolarize earlier resulting in myocardial heterogeneous repolarization.