房间传导时间测定在慢性肺原性心脏病中的应用

The Application of the Measurement of Atrioventricular Conduction Time in the Study of Chronic Pulmonary Heart Disease

目的:测量房间传导时间并观察其与慢性肺原性心脏病患者右房、右室及右心功能不全严重程度的关系。方法:用三导心电图机同步记录食道单极心电图和体表V_1、V_6导联,测定右房、右室内径。结果:正常人与肺心病组房间传导时间有显著差异性(P<0.001)。在50例肺心病患者中右心增大40例,其中心功能Ⅰ～Ⅱ级与心功能Ⅲ级相比,房间传导时间有差异性(P<0.05)。正常人组与肺心病组右房、室内径大小有显著差异性(P<0.01),心功能Ⅰ～Ⅱ级与Ⅲ级右房右室大小亦有差异性(P<0.05)。在20例右房内径增大患者中,其房间传导时间与右房内径呈明显正相关(r=0.913)。结论:房间传导时间越长,右心越大,心功能越差。本测定方法具有无创、简便易行及重复性好等特点,它对估计病情,判断预后、指导治疗及减少病死率有一定意义。

Objective: To investigate the relationship between the atrioventricular conduct time ( ACT) and the severity of right atrial and ventricular failure, and right heart failure of chronic pulmonary heart disease (CPHD) patients. Methods: Three-channel electrocardiography (ECG) was used to record both transesophageal unipolar atrial ECG and surface ECG by V1 and V6 lead at the same time on 60 normal people (NP) and 50 CPHD patients ( CP). The inner diameters of right atrium and right ventricle were measured. Results: There were significant differences of ACT and the inner diameter of right atrium between the NP group and CP group (P <0. 001, P <0. 001). 40 of the 50 patients in CP group had enlarged right heart. A positive correlation was found between the ACT and the inner diameter of right atrium in 20 patients with enlarged right heart (r =0, 913). There was also great difference of ACT between patients with cardiac function grade Ⅰ- Ⅱ and grade Ⅲ ( P < 0. 05 ) . Conclusions: The longer the ACT, the more serious the right heart enlargement and the cardiac function failure. This method is noninvasive, handy and can be well repeated which contributes to the severity evaluation, the prognosis, and the guidance for treatment of the disease, so as to reduce its death rate.