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目的 分析研究慢型克山病猝死前的心电图变化,为克山病防治研究提供有价值的资料。方法 应用心电图检查现存的慢型克山病,然后追踪观察慢型克山病猝死前的心电图表现。结果 猝死前慢型克山病在心电图上QRS波时间的均值为0 .17ms、V5的VAT时间的均值为0 . 0 73ms ,猝死的病人均有VPB ,合并左心室大劳损、左房大的各有5例,合并LAB的有4例,合并CRBBB、CLBBB、Ⅰ度AVB各有3例,合并右室大劳损的有2例,合并LPB、短阵室速、预激综合征、房性早搏的各1例。8例均有ST -T的异常,Ptf -V1<-0 .0 3mm·s、Q -T间期延长各有5例,TV1>TV5有4例,Q波异常有2例,QRS波有低电压倾向的2例。结论 导致慢型克山病猝死的主要心电图改变是VPB、QRS波和V5的VAT时间明显延长、Ptf -V1负值增大、CRBBB、LAB、Ⅰ度AVB、CLBBB、ST -T异常、Q -T间期延长、TV1>TV5、Q波异常和QRS波的低电压倾向。
Objective To analyze the changes of ECG before the sudden death of chronic Keshan disease and provide valuable information for the study of prevention and treatment of Keshan disease. Methods Electrocardiogram (ECG) was used to examine the existing chronic Keshan disease and then to observe the ECG before sudden death of chronic Keshan disease. Results The mean QRS wave time of chronic Keshan disease before the sudden death was 0.17ms on the electrocardiogram, the mean of VAT time of V5 was 0. 073ms, the patients with sudden death had VPB, the left ventricular large strain, left atrium large There were 5 cases in each group. There were 4 cases with LAB, 3 cases with CRBBB, CLBBB and Ⅰ degree AVB, 2 cases with right ventricular strain, LPB, SVT, One case of premature beat. 8 cases had ST-T abnormalities, Ptf -V1 <-0.03mm · s, Q-T interval prolongation in 5 cases each, TV1> TV5 in 4 cases, Q wave abnormalities in 2 cases, QRS waves Low voltage tendency in 2 cases. Conclusions The main electrocardiographic changes that lead to the sudden death of chronic Keshan disease are VPB, QRS wave and V5, the prolongation of VAT time, the increase of negative Ptf-V1, the abnormality of CRBBB, LAB, AVB, CLBBB, ST- T interval prolongation, TV1> TV5, Q wave anomaly and QRS wave low voltage tendency.