中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
11期
970-974
,共5页
王靖%贾玉和%毛克修%陈旭华%赵英杰%韦伟%张玉梅%祝夏阳%陶燕%华伟%张澍%楚建民
王靖%賈玉和%毛剋脩%陳旭華%趙英傑%韋偉%張玉梅%祝夏暘%陶燕%華偉%張澍%楚建民
왕정%가옥화%모극수%진욱화%조영걸%위위%장옥매%축하양%도연%화위%장주%초건민
心室颤动%心电描记术
心室顫動%心電描記術
심실전동%심전묘기술
Ventricular fibrillation%Electrocardiography
目的 分析特发性心室颤动(室颤)患者的心电图与临床特征,探讨其与预后之间的关系.方法 21例特发性室颤患者,男性10例(47.6%),初次发生症状年龄平均(38.5±19.0)岁,随访分析其临床及体表心电图特征,按照心电图有无J波分为J波阳性组(J+组)和J波阴性组(J-组),比较两组死亡和室颤、晕厥发生的情况.结果 21例特发性室颤的患者中,9例室颤发生于凌晨睡眠时,5例室颤发生于情绪激动时,7例室颤发作无明确诱因.J+组(n=15)中有7例心电图J波合并QRS波切迹,1例合并早期复极.合并QRS波切迹的7例患者室颤发作时间为凌晨睡眠中.平均随访(42.4±39.9)个月后,J+组患者的年平均室颤发作次数明显高于J-组(n=6),分别为(1.3±0.5)次/年和(0.4±0.3)次/年,P＜0.01.J+组死亡2例,J-组死亡1例.多因素回归分析结果显示,特发性室颤患者中J波阳性患者出现室颤复发的危险性高于J波阴性患者(RR 1.9,95%CI 1.1～2.9;P=0.03).结论 报道QRS波切迹的室颤患者有相似的凌晨睡眠时发作特点;J波在特发性室颤患者中的发生率较高,而且预示着具有更高的室颤复发率.J波有望成为特发性室颤预后的预测因子.
目的 分析特髮性心室顫動(室顫)患者的心電圖與臨床特徵,探討其與預後之間的關繫.方法 21例特髮性室顫患者,男性10例(47.6%),初次髮生癥狀年齡平均(38.5±19.0)歲,隨訪分析其臨床及體錶心電圖特徵,按照心電圖有無J波分為J波暘性組(J+組)和J波陰性組(J-組),比較兩組死亡和室顫、暈厥髮生的情況.結果 21例特髮性室顫的患者中,9例室顫髮生于凌晨睡眠時,5例室顫髮生于情緒激動時,7例室顫髮作無明確誘因.J+組(n=15)中有7例心電圖J波閤併QRS波切跡,1例閤併早期複極.閤併QRS波切跡的7例患者室顫髮作時間為凌晨睡眠中.平均隨訪(42.4±39.9)箇月後,J+組患者的年平均室顫髮作次數明顯高于J-組(n=6),分彆為(1.3±0.5)次/年和(0.4±0.3)次/年,P＜0.01.J+組死亡2例,J-組死亡1例.多因素迴歸分析結果顯示,特髮性室顫患者中J波暘性患者齣現室顫複髮的危險性高于J波陰性患者(RR 1.9,95%CI 1.1～2.9;P=0.03).結論 報道QRS波切跡的室顫患者有相似的凌晨睡眠時髮作特點;J波在特髮性室顫患者中的髮生率較高,而且預示著具有更高的室顫複髮率.J波有望成為特髮性室顫預後的預測因子.
목적 분석특발성심실전동(실전)환자적심전도여림상특정,탐토기여예후지간적관계.방법 21례특발성실전환자,남성10례(47.6%),초차발생증상년령평균(38.5±19.0)세,수방분석기림상급체표심전도특정,안조심전도유무J파분위J파양성조(J+조)화J파음성조(J-조),비교량조사망화실전、훈궐발생적정황.결과 21례특발성실전적환자중,9례실전발생우릉신수면시,5례실전발생우정서격동시,7례실전발작무명학유인.J+조(n=15)중유7례심전도J파합병QRS파절적,1례합병조기복겁.합병QRS파절적적7례환자실전발작시간위릉신수면중.평균수방(42.4±39.9)개월후,J+조환자적년평균실전발작차수명현고우J-조(n=6),분별위(1.3±0.5)차/년화(0.4±0.3)차/년,P＜0.01.J+조사망2례,J-조사망1례.다인소회귀분석결과현시,특발성실전환자중J파양성환자출현실전복발적위험성고우J파음성환자(RR 1.9,95%CI 1.1～2.9;P=0.03).결론 보도QRS파절적적실전환자유상사적릉신수면시발작특점;J파재특발성실전환자중적발생솔교고,이차예시착구유경고적실전복발솔.J파유망성위특발성실전예후적예측인자.
Objective To explore the association between clinical and ECG characteristics and prognoses in patients with idiopathic ventricular fibrillation (VF). Methods We reviewed the data from 21 VF patients [male 47.6%, mean age (38.5 ± 19.0) years] with first event of VF, all patients were resuscitated after cardiac arrest and diagnosed as idiopathic VF. The prevalence of J wave was assessed and patients were divided into J wave positive (J + group) and negative group (J - group). The end point was death or syncope from arrhythmia, and recorded VF recurrence during the follow-up. Results J wave was frequent in subjects with idiopathic VF (71.4%). Among patients in the J + group ( 15 cases), notch on the QRS wave was found in 7 subjects (46. 7% ), these patients were more likely to suffer from the sudden cardiac arrest during sleep at early morning than those with J wave but without notch on the QRS wave. Two patients dead suddenly in the J + group and l dead from embolism in the J - group during follow-up [ mean (42.4 ±39. 9) months]. The mean year-onset of VF or syncope was significantly higher in the J + group than in the J - group [ ( 1.3 ± 0. 5 ) episodes/year vs. (0. 4 ± 0. 3 ) episodes/year, P ＜ 0. 01 ]. J wave positive was also associated with an increased risk of VF recurrence ( RR 1.9, 95% CI 1.1 to 2. 9, P =0. 03). Conclusion J wave prevalence is high in patients with history of idiopathic VF, and positive J wave is associated with high risk of recurrence of sudden cardiac death.
