【摘要】 目的探讨室性早搏形态有明显宽的顿挫或切迹(以下称室性早搏丑征)与冠脉病变及其严重程度的关系。方法选择心内科住院病人,动态心电图检查有室性早搏>100个/24 h共171例作为研究对象,除外影响早搏形态的常见心肌病变、心功能不全等病人,观察所有病例室性早搏形态及有无ST-T异常改变与冠状动脉造影结果对照,进行对比分析。结果冠心病各组室性早搏丑征阳性及ST-T改变比例明显高于对照组,且差异具有统计学意义(P<0.001)。丑征与冠脉病变及ST-T改变呈正相关,且丑征阳性例数较ST-T改变例数高。冠心病组与正常对照组室早负荷及RF值无统计学意义(P>0.05)。丑征在胸导联出现较多,与冠脉病变中前降支病变较多相吻合。结论室性早搏形态的特殊改变"室性早搏丑征"可作为评价冠脉病变及其严重程度的另一指标,以进一步提高动态心电图在冠心病诊断中的应用价值。更多还原

【Abstract】 Objective The aim of this study was to investigate the relationship between the morphology of premature ventricular beat( PVB)which had obvious wide setback or notch( called PVB ugly sign) and coronary artery disease( CAD) and its severity. Methods We enrolled171 subjects admitted in the Department of Cardiology as the research object,which had PVB > 100 /24 h found by dynamic electrocardiogram. The influence factors of the ECG morphology of PVB such as patients with cardiomyopathy,cardiac dysfunction patients etc were excluded. Subsequently,association between the PVB morphology,ST-T anomaly change and the results of coronary angiography was analysed. Results The ratio of PVB ugly sign positive and ST-T changes in CAD group was significantly higher than that in control group(P < 0. 001).The PVB ugly sign was positively correlated with coronary lesions and the change of ST-T,and the number of the ugly sign positive cases was more than ST-T change cases. There was no statistical difference in premature ventricular load and RF value between CAD group and normal control group(P > 0. 05). The ugly sign appear more in the precordial leads,the result was matched the high incidence of coronary artery lesions in the anterior descending. Conclusion The PVB ugly sign could be used as an tool to evaluate coronary lesions and its severity,and further improved the application value of dynamic electrocardiogram in diagnosis of CAD.更多还原