左束支传导阻滞对左心室功能影响的研究

Effect of Left Buddle-Branch Block on Left Ventricular Function

目的探讨不同情况下左束支传导阻滞(LBBB)患者心功能变化的差异,分析LBBB对左心室功能产生不利的影响因素。方法选取我院2007年4月—2009年3月42例住院LBBB患者为研究对象,根据心功能分为心功能代偿组(A组,n=28)和心功能失代偿组(B组,n=14),对比分析病因、常规心脏超声、心肌组织多普勒成像(TDI)及心电图的相关数据。结果两组LBBB患者基本情况比较,差异均无统计学意义(P>0.05)。两组LBBB患者左心室舒张功能指标比较,差异均有统计学意义(P<0.05);两组LBBB患者左心室收缩功能指标比较,差异均无统计学意义(P>0.05);两组LBBB患者TDI指标比较,差异均有统计学意义(P<0.05);两组LBBB患者心电图指标QRSd比较,差异无统计学意义(P>0.05);而QRSD比较,差异有统计学意义(P<0.05)。结论 LBBB患者心功能改变主要取决于原发病和心肌受累程度,心电图QRS离散度及TDI的相关指标对评价LBBB患者左心室及室间不协调运动情况有更大的帮助。

Objective To analyze the effect of left buddle-branch block （LBBB） on left ventricular function.Methods Totally 42 inpatients with LBBB from April,2007 to March,2009 were enrolled in this study.Based on their ventricular functions,these LBBB patients were divided into group A （NYHA grade I-II;n=28） and group B （NYHA III-IV;n=14）.The underlying causes,electrocardiogram,routine echocardiography,and tissue Doppler imaging （TDI） data were compared.Results The baseline data were not significantly different between two groups（P0.05）.Although the left ventricular systolic function-related indicators were not significantly different between these two groups （P0.05）,the left ventricular diastolic function-related indicators showed significant differences （P0.05）.TDI indicators and QRSD were significantly different,while QRSd was not（P0.05）.Conclusion The changes of the left ventricular function in LBBB patients mainly depend on the primary diseases and the extent of myocardial involvement.ECG QRSD and TDI can be more helpful in evaluating the asynchrony movement in the left ventricle and between ventricles.