• λ波是冠心病患者发生恶性心律失常的新预测因子
  • 郑晓波.λ波是冠心病患者发生恶性心律失常的新预测因子[J].内科急危重症杂志,2021,27(6):462-467
    DOI:10.11768/nkjwzzzz20210605
    中文关键词:  冠心病  心电图  λ波  恶性心律失常
    英文关键词:
    基金项目:
    作者单位E-mail
    郑晓波 潍坊医学院心内科 chuhx1972@163.com 
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    中文摘要:
          摘要 目的:本研究探讨λ波与冠心病(CAD)患者发生恶性心律失常的相关性及可能的机制。方法:收集2018年3月-2020年1月就诊于潍医附院和烟台市毓璜顶医院心血管内科60例CAD患者的临床资料,根据有无λ波分为λ波组(20例)及对照组(40例),对CAD患者行心电图或动态心电图检查,分析λ波形及恶性心律失常发生情况,比较2组之间有无统计学差异。结果:与对照组比较,λ波组晕厥、心律失常及心脏骤停、冠脉痉挛发生率更高(55% vs 7.5%;100% vs 17.5%;40% vs 0%;90% vs 2.5%,P均<0.01)。观察2组心电图分布及形态差异,λ波组中顿挫型J点更常见,λ波主要位于下壁和侧壁导联(90% vs 20%;80% vs 15%,P均<0.01)。λ波组患者严重缓慢心律失常和/或室性心律失常的发生率明显升高(80% vs 10%;85% vs 7.5%,P均<0.01)。结论:λ波常出现在下壁、侧壁导联,可能是预测冠心病患者恶性心律失常发生的一个危险标志。顿挫型J波比平滑型J波更易发生恶性心律失常。λ波形成可能与急性心肌缺血及基因突变有关。
    英文摘要:
          Abstract Objective: To explore the correlation between λ wave and malignant arrhythmia in patients with coronary heart disease (CHD) and its possible mechanism. Methods: The data of 60 CAD patients were collected from Affiliated Hospital of Weifang Medical College and Yuhuangding Hospital of Yantai from March 2018 to January 2020. According to the presence of λ wave, the patients were divided into λ wave group (20 cases) and control group (40 cases). The λ waveform and malignant arrhythmia from electrocardiograms or dynamic electrocardiograms were analyzed, and compared between the two groups. Results: The incidence of syncope, arrhythmia and sudden cardiac arrest, coronary artery spasm was higher in the λ wave group than in the control group (55% vs 7.5%; 100% vs 17.5%; 40% vs 0%; 90% vs 2.5%, P<0.01).The distribution and morphological differences of ECG between the two groups were observed. In λ wave group, notched J point was more common (90% vs 20%, P<0.01), and λ wave was mainly located in the lower and lateral leads (80% vs 15%, P<0.01). The incidence of severe bradyarrhythmias and/or ventricular arrhythmias was significantly increased in the λ wave group(80% vs 10%, P<0.01; 85% vs 7.5%, P<0.01). Conclusion: The λ wave often appears in lower wall and lateral wall leads, which may be a risk marker for predicting malignant arrhythmias in patients with CHD. Notched J wave is more likely to cause malignant arrhythmia than smooth J wave. The formation of λ wave may be related to acute myocardial ischemia and gene mutation