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目的观察扩张型心肌病患者心电图的表现和诊断情况。方法对45例扩张型心肌病患者的临床资料进行回顾性分析,观察扩张型心肌病患者的心电图表现。结果所有患者均表现为左心扩大同时左心室射血分数降低,左心房内径(48.7±5.2)mm,左心室舒张末期内径(70.2±8.6)mm,左心室收缩末期内径(59.7±8.1)mm,左心室射血分数(30.4±5.5)%。患者的心电图表现异常包括ST-T改变、室性早搏、窦性心动过缓、房性早搏、传导阻滞、窦性心动过速、心房颤动以及异常Q波,其中ST-T改变15例(33%),室性早搏6例(13%),窦性心动过缓4例(9%),房性早搏3例(7%),传导阻滞10例(22%),窦性心动过速3例(7%),心房颤动2例(4%),异常Q波2例(4%)。患者心率为(82.9±11.2)次/min,QRS时限为(116.8±30.7)ms,Qtc为(440.4±35.2)ms,传导阻滞类型包括Ⅰ度房室传导阻滞2例(4%),左前分支传导阻滞2例(4%),室内阻滞3例(7%),左束支传导阻滞1例(2%)。结论心电图出现QRS时限延长、心房颤动等患者要及时予以心脏超声检查,及早确诊是否为扩张型心肌病。
Objective To observe the manifestation and diagnosis of ECG in patients with dilated cardiomyopathy. Methods The clinical data of 45 patients with dilated cardiomyopathy were retrospectively analyzed to observe the ECG findings in patients with dilated cardiomyopathy. Results All the patients presented with left ventricular enlargement and decreased left ventricular ejection fraction. The left atrial diameter (48.7 ± 5.2) mm, left ventricular end diastolic dimension (70.2 ± 8.6) mm, left ventricular end systolic diameter (59.7 ± 8.1) mm , Left ventricular ejection fraction (30.4 ± 5.5)%. Patients with ECG abnormalities including ST-T changes, premature ventricular contractions, sinus bradycardia, atrial premature beats, conduction block, sinus tachycardia, atrial fibrillation and abnormal Q wave, including ST-T changes in 15 cases ( 33%), ventricular premature beat in 6 cases (13%), sinus bradycardia in 4 cases (9%), atrial premature beat in 3 cases (7%), conduction block in 10 cases Three cases were fast (7%), two cases were atrial fibrillation (4%) and two cases were abnormal Q wave (4%). The heart rate was (82.9 ± 11.2) beats / min, the QRS duration was (116.8 ± 30.7) ms, the Qtc was (440.4 ± 35.2) ms, the type of conduction block included grade Ⅰ AV block in 2 cases (4% There were 2 cases of left anterior branch block (4%), 3 cases of intracranial block (7%) and 1 case of left bundle branch block (2%). Conclusion Electrocardiogram QRS prolongation of time, atrial fibrillation and other patients should be timely echocardiography, early diagnosis of dilated cardiomyopathy.