摘要
目的 观察肥厚型心肌病 (HCM )患者QT离散度 (QTd)与左室重量 (LVM)关系 ,探讨HCM患者心室肌复极电活动稳定性及引起其不稳定的主要原因。方法 HCM患者 6 4例 ;梗阻组 (HOCM ) 33人 ;非梗阻组 (HNCM ) 31例 ;对照组健康人 32例。三组均做 12导联同步心电图及超声心动图。测定三组QTd、心率校正的QT离散度 (QTcd)、舒张期左室内径 (LVEDD) ,舒张期室间隔厚度 (IVST)及左室后壁厚度 (LVPWT) ,计算出LVM。结果 ①HCM组 (包括HOCM组和HNCM组 )LVM、IVST、QTd、QTcd较正常对照组显著提高 (P <0 0 5 ) ;HOCM组与HNCM组上述指标无统计学差别(P >0 0 5 ) ;②HCM患者QTd与LVM呈正相关 ,r为 0 32 5 ;③HCM患者QTd与IVST呈正相关 ,r为 0 4 6 3。结论 HCM患者心室肌复极电活动有着不稳定性及不同步性 ,具有很强的心律失常易感性和心律失常源性 ,可能与左室肥厚的程度 ,重量的增加有关 ,与LVOT有无梗阻无关。
Objectives To observe the relationship between QT dispersion and the mass of left ventricle in hypertrophic cardiomyopathy, and find whether in HCM paitents the sensitivity to electrical instability of ventricular repolarization is increased and its chief reasons. Methods In this study, 64 cases of in-patients with HCM were divided into two groups: 33 cases in obstructive cardiomyopathy group and 31 cases in non-obstructive cardiomyopathy group. 32 cases of healthy person were selected. Collect 12-lead-system electrocardiogram and ultrasonic echo cardiogram for each case were collected . QTd measurement: QTd(QTd=QTmax-QTmin), QTcd(QTcd=QTd/(R-R) 1/2 ). Ultrasonic data record and calculating: LVM(g)=1.04[(LVEDD+IVST+LVPWT) 3+(LVEDD) 3]-1.36.Results HCM group(including obstructive group and non-obstructive cardiomyopathy group)LVM,QTd QTcd enhanced obuiously comparing to the comparison group(P<0.05) and have no difference in statistics in the obstructive cardiomyopathy group and non-bostructive cardiomyopathy group(P>0.05). QTd and LVM were positively correlated in HCM patients, r was 0.325. QTd and IVST were positively correlated in HCM patients, r was 0.436.Conclusions Left ventricle and interventricular septum thickness elevate obviously in HCM patients in comparison to the normal person. HCM patients have un-synchronization and electrical instability of ventricular repolarization. They have more possibility and sensitivity of ventricular arrhythmia. The hypertrophy of left ventricle and the interventricular septum is the main cause of the increase of QTd, QTcd in HCM patients, but not because LVOT's obstruction.
出处
《岭南心血管病杂志》
2004年第6期430-433,共4页
South China Journal of Cardiovascular Diseases
