PJ间期对鉴别间歇性宽QRS波的意义

Significance of PJ interval in differentiating the intermittent wide QRS wave

目的分析PJ间期在鉴别间歇性宽QRS波(即间歇性WPW预激综合征、间歇性束支阻滞及舒张晚期室性早搏)中的意义。方法随机收集我院2018年1月至2020年1月动态心电图诊断为舒张晚期室性早搏、间歇性WPW预激综合征、间歇性束支传导阻滞患者分成三组,每组各50例,分析三组研究对象的PJ间期与其自身窦性激动经房室交界及左右束支正常传导下传心室时产生的PJ间期的变化。结果50例间歇性WPW预激综合征组中,PJ间期分别为(237.04±18.38)ms、(232.46±17.98)ms,差异无统计学意义(P>0.05)。50例舒张晚期室性早搏组中,PJ间期分别为(207.06±29.32)ms、(238.82±28.26)ms,舒张晚期室性早搏的P-J间期不同程度缩短,且变异性大,差异有统计学意义(P<0.05)。50例间歇性束支传导阻滞组中,PJ间期分别为(284.25±32.41)ms、(241.75±27.78)ms,束支传导阻滞的PJ间期明显延长,差异有统计学意义(P<0.05)。结论舒张晚期室性早搏时PJ间期缩短,间歇性WPW预激综合征发生时PJ间期基本不变,间歇性束支阻滞时PJ间期延长,对心电图间歇出现宽QRS波群时,PJ间期的对比测量结果可以作为三者鉴别诊断的参考依据。

Objective To analyze the significance of the PJ interval in differentiating the intermittent wide QRS wave(i.e.intermittent preexcitation syndrome,intermittent bundle branch block and late diastolic premature ventricular beat).Methods A total of 50 patients with late diastolic premature ventricular beat,50 patients with intermittent WPW preexcitation syndrome,50 patients with intermittent bundle branch block diagnosed by dynamic electrocardiogram in our hospital from January 2018 to January 2019 were selected as the research objects and randomly divided into 3 groups.The PJ interval of the three groups of subjects were compared and analyzed with the PJ intervals generated when their sinus excitation was transmitted to the ventricles through the atrioventricular junction and the left and right bundle branches.Results In the 50 intermittent WPW preexcitation syndrome,there was no significant difference in the PJ interval(237.04±18.38)ms,(232.46±17.98)ms,respectively(P>0.05).In the 50 late diastolic premature ventricular beat,the PJ interval was(207.06±29.32)ms and(238.82±28.26)ms,respectively.It was shortened to different degrees with great variability,with statistically significant difference(P<0.05).In the 50 intermittent bundle branch block,the PJ interval was(284.25±32.41)ms and(241.75±27.78)ms,respectively.It was significantly prolonged,with statistically significant difference(P<0.05).Conclusion When the late diastolic premature ventricular beat occurs,the PJ interval is shortened.When the intermittent WPW preexcitation syndrome occurs,the PJ interval is basically unchanged.When the intermittent bundle branch block occurs,the PJ interval is prolonged.The comparative measurement results of the PJ interval can be used as the reference for the differential diagnosis of the three.