12导联同步体表心电图T波振幅对扩张型心肌病的评价

Clinical Evaluation of 12-Lead Electrocardiographic T-Wave Amplitude in Children with Dilated Cardiom-yopathy

目的评价12导联同步体表心电图（12ECGs）T波振幅在儿童扩张型心肌病（DCM）诊断和治疗中的价值。方法DCM患儿27例为研究组。男14例，女13例；年龄3个月～14岁，平均5．37岁。随机匹配健康儿童27例为对照组。受检对象描记12ECGs，测量波形清晰12导联T波振幅。其中10例DCM患儿经氢氯噻嗪、依那普利、美托洛尔、螺内酯等综合治疗后随访5～39d，平均19．67d。结果研究组较对照组T波振幅在Ⅰ、Ⅱ、aWR、aⅥJ、aⅤF、Ⅴ4、Ⅴ5、Ⅴ6导联明显降低（P均〈0．05），Ⅲ、Ⅴ2、Ⅴ，导联稍降低（P均〉0．05），Ⅴ1导联T波振幅增高（P〈0．05）。DCM患儿治疗后较治疗前T波振幅在Ⅲ、aⅤF导联明显增高（P〈0．05），Ⅱ、aWR、aⅤF、U导联稍增高（P均〉0．05），Ⅰ、aⅤL、Ⅴl～Ⅴ4、Ⅴ6导联稍降低（P均〉0．05）。结论动态观察12ECGs的T波振幅，对儿童DCM诊断和评价疗效具有客观指导价值。

Objective To evaluate the clinical diagnosis and therapeutic effect of 12 - lead electrocardiographic T - wave amplitude in children with dilated cardiomyopathy（DCM）. Methods 12 - lead electrocardiograms（ 12 ECGs） were taken from 27 cases in children with DCM（research group） aged from 3 months to 14 years old （mean 5.37 years）, 27 healthy children （control group）, and 10 cases which treated with dihydrochlorothiazede enalapril spironolactone metoprolol and followed up from 5 to 39 days （mean 19.67 days）. The T- wave amplitude was tested in the clear 12 ECGs. Results Compared with control group on T - wave amplitude, Ⅰ,Ⅱ, aVR, aⅤL, aⅤF, Ⅴ4, Ⅴ5,Ⅴ6 leads obviously decreased （ P〈0.05） ; Ⅲ, Ⅴ2,Ⅴ3 leads slightly decreased （P〉0.05） ; Ⅴ1 lead increased （ P 〈0.05 ）. Compared with the group before treating on T- wave amplitude, Ⅲ, aⅤF leads obviously increased（P〈0.05） ; Ⅱ , aVR, aⅤF, Ⅴ5 leads slightly increased（P〉0.05） ; Ⅰ ,aⅤL,Ⅴ1 -Ⅴa,Ⅴ6 lead slightly decreased（P〉0.05）. Conclusion 12 - lead electrocardiographic T- wave amplitude has the objective and leading value to clinical diagnosis and treatment in children with DCM.