心电图低电压在亚急型克山病预后中的意义

SIGNIFICANCE OF THE LOW-VOLTAGE IN ELECTROCARDIOGRAM FOR PROGNOSIS OF SUBACUTE KESHAN DISEASE

作者观察的亚急型克山病１５３例中，心电图发生低电压者９７例（６３．４％），其中死亡４２例，病死率４３．３％，为非低电压组的１．３５倍，其临床痊愈率（３６．１％）明显低于后者（５３．６％），Ｐ＜０．０５。低电压组合并其他心肌损害的心电图改变如病理性Ｑ波、ＳＴ－Ｔ异常、完全或不完全性右束支阻滞等明显多于非低电压组，Ｐ＜０．０５或Ｐ＜０．０１，表明心肌损害广泛。ＱＲＳ电压随病情的改善或加重有动态变化，故心电图ＱＲＳ电压及其变化可作为评估亚急型克山病预后的重要指标之一。

The low-voltage in electrocardiogram(LE)was found in 97 cases(63.4%)of 153 patients with subacute Keshan disease. Among them, 42 cases died,the mortality rate(43.3%)was 1. 35 times the rate of cases with non-LE.The clinical cure rate (36.1%)was lower than that of cases without LE (53.6%),P<0.05.The other ECG abnormalities from myocardiac injury in the LE cases occurred significantly more frequently than in the cases without LE.These obnormalities included pathologic Q waves. ST-T changes and complete or incomplete right bundle branch block , showing that the myocardiac injury was more severe in the LE cases than in non-LE patients,P<0. 05 or 0. 01. The voltage of QRS waves changed dynamic with the improvement or worse of the clinical conditions,indicating that the changes of QRS waves voltage might be used as one of important indicators for assessing the prognosis of subacute Keshan disease.