完全性左束支阻滞伴电轴左偏对患者左室功能的影响

Effect of complete left bundle branch block with left axis deviation on patients' left ventricular function

目的探讨完全性左束支阻滞伴电轴左偏对患者左室功能的影响,以便更好地判断患者预后。方法选取我院2009年1月至2014年5月期间常规心电图诊断为完全性左束支阻滞(CLBBB)且资料完整的住院患者365例进行回顾性分析,所有患者均进行常规心电图及超声心动图检查,将365例患者按单纯CLBBB(A组,n=267)和CLBBB伴电轴左偏(LAD)(B组,n=98)进行分组,比较两组患者的年龄、性别、病史、电轴、左室舒张末径、左室收缩末径、EF(左室射血分数)、E/A(舒张早期血流速度峰值/舒张晚期血流速度峰值)比值。结果 AB两组的高血压及心功能不全比例比较差异均无统计学意义(P>0.05);B组患者的年龄、男性比例和冠心病比例均高于A组,差异均有统计学意义(P<0.05),但EF低于A组,差异有统计学意义(P<0.01)。结论在CLBBB患者中,男性、年龄增大、冠心病是LAD发生的危险因素,而CLBBB伴LAD较单纯CLBBB更易损伤左室收缩功能。

Objective To investigate the effect of complete left bundle branch block （CLBBB） with left axis deviation （LAD） on patients＇ left ventricular function, in order to better evaluate the prognosis. Methods The study included a total of 365 CLBBB patients with complete data hospitalized from Jan. 2009 to May 2014. All patients had taken the examinations of electrocardiograph （ECG） and ultrasonic cardiogram （UCG）. The patients were divided into two groups：only CLBBB （group A, n=267） and CLBBB with LAD （group B, n=98）. The data of age, gender, medical history, electrical axis of heart, left ventricular end-diastolic diameter （LVEDD）, left ventricular end-systolic diameter （LVESD）, ejection fraction （EF）, peak early diastolic velocity （E） and late diastolic velocity （A） and their ratio （E/A） were observed and compared between the two groups. Results The two groups showed no statistically significant dif-ference in the incidence of hypertension and cardiac insufficiency （P〉0.05）. Patients in group B had a higher ratio of male, coronary heart disease （CHD） and older age than those in group A （P〈0.05）, while a lower EF was found in group B （P〈0.01）. Conclusion In patients with CLBBB, male, older age and CHD are the risk factors of LAD. CLBBB patients with LAD have a lower left ventricular systolic function than CLBBB patients without LAD.