心内膜心肌纤维化病与Ebstein畸形的心电图对比研究

Comparative study of electrocardiographic findings in the patients with endomyocardial fibrosis and Ebstein's anomaly of the tricuspid valve

目的 探讨有右室受累的心内膜心肌纤维化病（ＥＭＦ）与Ｅｂｓｔｅｉｎ 畸形的心电图区别。方法 比较１５例有右室受累的ＥＭＦ患者（Ａ组）和３２ 例Ｅｂｓｔｅｉｎ 畸形患者（Ｂ组）的心电图表现。结果 心房扑动或颤动，低电压的发生率Ａ 组明显高于Ｂ组患者（分别为４０％ 与３％ ，Ｐ＝ ０．０３０；４０％ 与９％ ，Ｐ＝０．０２１）；右束支阻滞、右房肥大、Ⅰ度房室阻滞、Ｂ型预激综合征的发生率Ｂ组比Ａ 患者明显增高（分别：７５％ 与２０％ ，Ｐ＝ ０．０１０；７１％ 与２７％ ，Ｐ＝ ０．００５；４４％ 与０％ ，Ｐ＝ ０．０２０；３１％ 与０％ ，Ｐ＝ ０．０１９）；房性早搏或室性早搏、左房肥大在两组之间均无显著性差异（Ｐ均＞ ０．０５）。结论 心电图表现有助于有右室受累的ＥＭＦ与Ｅｂｓｔｅｉｎ 畸形鉴别诊断。

Objective To explore the difference of electrocardiographic findings between endomyocardial fibrosis(EMF) involving right ventricular and Ebstein's anomaly of the tricuspid valve.Methods Electrocardiographic findings were compared between EMF in which right ventricular was involved (group A) and Ebstein's anomaly of the tricuspid valve (group B).Fifteen patients with group A and thirty-two patients with group B were studied.Results The incidence rate of atrial flutter or fibrillation,low voltage in group A is apparetly higher than those in group B (40%vs 3%, P =0 030;40%vs,9%, P =0 021);While the incidence rate of right bundle branch block,right atrial enlargement,the first degree atrioventricular block,the type B WPW syndrome in group B is significantly higher thanthose in group A (75%vs,20%, P =0 010;71%vs,27%, P =0 005,44%vs,0%, P =0 020;31%vs,0%, P =0 019)。There was no significant difference in the incidence rate of left atrial enlargement and atrial or ventricular premature beat betwee the two groups.Conclusion Electrocardiographic findings contribute to differential diagnosis between EMF in which right ventricular was involved and Ebstein's anomaly of the tricuspid valve.