完全性右束支传导阻滞并左前分支阻滞 T环特点及意义

目的:探讨完全性右束支传导阻滞(CRBBB)并左前分支传导阻滞(LAFB)的T环形态及异常的临床价值.方法:对正常人(对照组)和陈旧性心肌梗死患者(OMI组)各50例及心电图(ECG)符合CRBBB加LAFB诊断(CRBBB加LAFB组)84例行心电向量图(VCG)检查.根据临床资料CRBBB加LAFB组分为无器质性心脏病的正常亚组(A组,39例)和有器质性心脏病的异常亚组(B组,45例).分析T向量环改变及临床意义.结果:对照组T环形态多呈狭长型,占96%(48/50);OMI组T环多呈圆小型、狭小型和圆长型,占94.0%(47/50),2组比较差异有统计学意义(P＜0.05).CRBBB加LAFB组:A组T环形态呈狭长型94.9%(37/39);B组T环形态呈圆小型、狭小型和圆长型占84.4%(38/45),2组比较差异有统计学意义(P＜0.05).而A组与对照组比较差异无统计学意义(P＞0.05).结论:CRBBB加LAFB者VCG示T环呈圆小型、狭小型与心肌缺血有关,T环呈狭长型可能为传导系统原发性退行性变所致.

Clinic significance of abnormal vectorcardiogram T ring in CRBBB+LAFB

Objective:To investigate the clinic significance of abnormal vectorcardiogram T ring for diagnostic value in patients with RBBB plus LAFB.Method:The 12-lead ECG,9-lead timed vectorcardiogram(VCG) were performed and analyzed in 50 patients with old myocardial infarction(OMI group),50 normal persons(normal group),84 cases with RBBB plus LAFB(RBBB plus LAFB group).The later were divided into two subgroups,the patients without organic heart diseases(A group) and patients with them(B group).Result:The most shape of T ring was long and narrow in normal group(96%) and A group(94.9%).The shapes of T ring were either small and round type,narrow and small type or round and long type in OMI group(94%) and B group(84.4%).There was significant to the shapes in them(P<0.05).Conclusion:VCG suggests that the T ring with either round and small type or narrow and small type is associated with myocardial ischemia whereas the T ring with narrow and long type is related to original conducting system degenerate.