肥厚型心肌病患者ECG异常表现及其意义

Abnormal ECG manifestations and their significance in patients with hypertrophic cardiomyopathy

目的探讨肥厚型心肌病患者心电图(ECG)异常表现及其意义。方法选择2020年3月至2021年3月解放军305医院收治的135例肥厚型心肌病患者作研究对象,按照其肥厚部位不同将其划分为心尖肥厚型心肌病组(甲组,62例)和间隔肥厚型心肌病组(乙组,73例),均行ECG检查,比较两组患者室间隔厚度、V4~V6 T波倒置、-aVR导联倒置T波、Ⅲ导联R/S<1等指标的差异。结果甲组患者的室间隔厚度薄于乙组,差异有统计学意义(P<0.05);甲组患者中的V4~V6 T波倒置比例高于乙组,差异有统计学意义(P<0.05);甲组患者中的aVR导联倒置T波比例高于乙组,差异有统计学意义(P<0.05);甲组患者中心电图Ⅲ导联R/S<1、主波向下比例低于乙组,差异有统计学意义(P<0.05)。结论ECG能够在辅助鉴别诊断心尖肥厚型、间隔肥厚型心肌病中发挥出巨大作用,结合相关诊疗手段有助于提高患者早期确诊率,为后期治疗方案的制定奠定良好的诊断基础,其具有较高的临床应用价值。

Objective To explore the abnormal ECG manifestations and their significance in patients with hypertrophic cardiomyopathy.Methods A total of 135 patients with hypertrophic cardiomyopathy admitted to 305 Hospital of PLA from March 2020 to March 2021 were selected as research objects,and they were divided into the apical hypertrophic cardiomyopathy(group A,62 cases)and the septal hypertrophic cardiomyopathy(group B,73 cases)according to their hypertrophic parts.All of them were examined by electrocardiogram.The differences of ventricular septal thickness,V4-V6 T wave inversion,T-wave inversion of aVR lead andⅢlead R/S<1 were compared between the two groups.Results The thickness of ventricular septum in group A was thinner than that of group B,with a statistically significant difference(P<0.05).The inversion of V4-V6 T wave in group A was higher than that of group B,with a statistically significant difference(P<0.05).The ratio of aVR lead inversion T wave in group A was higher than that of group B,with a statistically significant difference(P<0.05).The main wave down was lower than that of group B,with a statistically significant difference(P<0.05).Conclusion Electrocardiogram can play a great role in the auxiliary differential diagnosis of apical hypertrophy and septal hypertrophy cardiomyopathy.Combined with relevant diagnosis and treatment methods,it can help improve the early diagnosis rate of patients and lay a good diagnostic basis for the formulation of later treatment plan,which has high clinical application value.