从动态心电图角度探讨室性早搏的临床意义

对２４小时动态心电图（ＤＣＧ）检出有室性早搏（ＰＶＢｓ）的５７５例进行分析。分为器质性心脏病组（Ⅰ组）和无器质性心脏病证据组（Ⅱ组），两组分别为３６７例和２０８例。结果显示≥ＬｏｗｎⅢ级以上的复杂性ＰＶＢｓ和≥３０次／小时的频发性ＰＶＢｓ发生率以Ｉ组明显为高，且又以心肌梗塞、扩张性心肌病、急性心肌炎为突出。Ⅰ组中７３例伴有充血性心力衰竭（ＣＨＦ），其复杂性ＰＶＢｓ又显著高于心功能正常者，频发性ＰＶＢｓ的发生率与心功能无明显关系。４７例同时检出室性心动过速（ＶＴ）共１４１阵次，其发生率Ⅰ组高于Ⅱ组，均呈短阵发作，自行终止。ＶＴ发作前多呈成对和／或多源形式出现。检出有ＲｏｎＴ或ＲｏｎＰ现象５６例，ＲｏｎＰ现象Ⅰ组明显多于Ⅱ组。ＲｏｎＴ现象在两组间检出率无明显差异。由ＲｏｎＰ现象诱发的成对ＰＶＢｓ或短阵ＶＴ远多于ＲｏｎＴ者。同时伴发其他心律失常或传导障碍Ⅰ组也多于Ⅱ组。本文认为，复杂性及频发性ＰＶＢｓ和短阵室速以器质性心脏病者多发并与其心脏病变的严重程度和／或心功能状态有关。多源与／或成对ＰＶＢｓ同ＶＴ发生有密切联系，表明ＰＶＢｓ的Ｌｏｗｎ分级对室性早搏的病理意义判定仍有一定价值，但并不完全，本组有１／３的频发或     

1050例室性早搏的DCG检测与分析

目的探讨室性早搏（PVBs）的发生规律及其与临床的联系.方法对1050例有PVBs的24h动态心电图（DCG）按有无器质性心脏病进行分组分析.结果复杂性和频发性PVBs及短阵室速（VT）以心脏病者多发（P＜0.005及P＜0.01）,且以冠心病、心肌病等病变范围广,病变程度重者发生率高.VT均呈短阵发作,自行终止,多无明显症状.结论复杂性、频发性PVBs及VT以心脏病者多发,并与心脏病变性质及程度严重程度有关.     

实验性大鼠增生前列腺组织中纤维连接蛋白的表达

目的：研究性激素对大鼠前列腺腹叶（ＲＶＰ）内纤维连接蛋白（ＦＮ）表达的影响。方法：Ｗｉｓｔａｒ雄性大鼠５２只随机分为三组：正常对照组，阉割组和阉割后用不同比例雌二醇（Ｅ２）与睾丸酮（Ｔ）处理组（Ｃ＋Ｅ２／Ｔ组），以免疫组化ＡＢＣ法观察ＲＶＰ内ＦＮ的表达。结果：阉割组ＦＮ表达增强（Ｐ＜００５），Ｃ＋Ｅ２／Ｔ组当Ｅ２／Ｔ＞１：２５０时ＦＮ表达明显增强（Ｐ＜００１）。结论：ＲＶＰ内ＦＮ的表达与Ｅ２和Ｔ的含量及平衡状态密切相关。     

2型糖尿病微血管病变患者脂蛋白(α)的变化

目的：探讨２型糖尿病人血清脂蛋白（α）水平与发生微血管病变的关系。方法：测定９１例糖尿病人,包括４４例伴微血管病变和４７例未发生微血管病变者的血清脂蛋白（α）（Ｌｐ（α）,ＡｐｏＡ,ＡｐｏＢ,ＴＣ,ＴＧ;血ＨｂＡｌ;尿ＮＡＧ和ＮＡＧ Ｂ等指标,与３２例对照组进行比较。结果：微血管病变的糖尿病人血清Ｌｐ（α）显著高于对照组。糖尿病肾脏并发症患者Ｌｐ（α）水平与ＴＣ（ｒ＝０．２３,Ｐ＜００５）,ＡＥＲ（ｒ＝０．６２,Ｐ＜０．０１）,ＮＡＧ Ｂ（ｒ＝０．５１,Ｐ＜００１）和ＮＡＧＩ（ｒ＝０．４１,Ｐ＜００５）呈现相关。结论：测定Ｌｐ（α）对辅助诊断糖尿病微血管病变有较好的临床价值。     

心肌梗塞患者心室晚电位的临床和随访分析

目的：研究心室晚电位（ＬＰ）与梗塞部位、恶性室性心律失常和心功能的关系，以及ＬＰ对心肌梗塞（ＭＩ）后发生室性心动过速／心室颤动（ＶＴ／ＶＦ）和猝死的预测作用。方法：用晚电位记录仪对１６８例ＭＩ患者进行检测和随访分析。结果：本组ＭＩ患者中ＬＰ的阳性检出率为２７％，多壁ＭＩ组ＬＰ阳性率明显高于前（间）壁ＭＩ组（Ｐ＜００５），ＶＴ／ＶＦ和猝死患者的ＬＰ阳性率明显高于无ＶＴ／ＶＦ患者（Ｐ＜００１），ＭＩ伴心功能不全者ＬＰ阳性率明显高于有ＭＩ但心功能Ⅰ级者（Ｐ＜００１）。结论：ＬＰ与ＭＩ范围的大小、心脏的功能状态以及ＶＴ／ＶＦ或猝死有密切关系，但陈旧性ＭＩ发生猝死可能与ＬＰ关系不大     

蝎毒抗癌多肽对肝癌小鼠免疫功能的影响

目的：观察蝎毒抗癌多肽（ａｎｔｉｎｅｏｐｌａｓｔｉｃｐｏｌｙｐｅｐｔｉｄｅｆｒｏｍＢｕｔｈｕｓｍａｒｔｅｎｓｉｖｅｎｏｍ,ＡＰＢＭＶ）对肝癌Ｈ２２带瘤小鼠ＮＫ细胞活性,外周血白细胞计数,淋巴细胞增殖,迟发型超敏反应和血清溶血素水平的影响。方法：将接种Ｈ２２细胞２４ｈ后的带瘤小鼠随机分为４组,每组１０只：空白对照组（等体积生理盐水,腹腔注射）,５Ｆｕ组（５Ｆｕ１０ｍｇ·ｋｇ－１）,ＡＰＢＭＶ组（ＡＰＢＭＶ００３ｍｇ·ｋｇ－１,腹腔注射）,ＡＰＢＭＶ＋５Ｆｕ组（ＡＰＢＭＶ００３ｍｇ·ｋｇ－１＋５Ｆｕ１０ｍｇ·ｋｇ－１,腹腔注射）,连续给药５ｄ。给药期间及给药后对带瘤小鼠进行相应的处理,观察经治疗后Ｈ２２带瘤小鼠上述指标的变化。结果：ＡＰＢＭＶ组及ＡＰＢＭＶ＋５Ｆｕ组带瘤小鼠的ＮＫ细胞活性和ＤＮＣＢ诱导的皮肤迟发型超敏反应明显增强,淋巴细胞转化指数明显增高,与对照组及单用５Ｆｕ组相比有显著差异（Ｐ＜００５或Ｐ＜０．０１或Ｐ＜０．００１）;ＡＰＢＭＶ单独应用使带瘤小鼠白细胞计数显著提高（与对照组相比Ｐ＜００１）,５Ｆｕ组白细胞计数明显减少（与对照相比Ｐ＜００１）,ＡＰＢＭＶ与５Ｆｕ联合应用     

脑血管病患者血浆内皮素水平的测定

目的探讨内皮素（ＥＴ）测定在脑血管病（ＣＶＤ）发病过程中的临床意义及与伴发症、病情的关系。方法用放射免疫分析法测定５８例ＣＶＤ患者的血浆总ＥＴ水平，并与５５例对照组比较。结果ＣＶＤ组血浆ＥＴ浓度明显升高（Ｐ＜０．００１），以病后第２周为分泌高峰；多发或再发梗死时高于单发病灶（Ｐ＜０．０５）；病情中、重型高于轻型（Ｐ＜０．０５）；伴发高脂血症者高于无高脂血症者（Ｐ＜０．０１）；有高血压病史者高于无高血压病史者（Ｐ＜０．０５）；有冠心病或高血压性心脏病史者高于无心脏病史者（Ｐ＜０．０５）；尿蛋白阳性者高于阴性者（Ｐ＜０．０５）。结论ＥＴ在ＣＶＤ的发生和发展中具有一定作用，与高血压、高血脂、冠心病、高血压性心脏病、肾脏损害存在一定的关系，ＥＴ含量变化与病情一致，可作为估计病情预后的指标之一。     

慢性乙肝急性加重期患者自然恢复和短期抗病毒干预 过程中的乙肝表面抗原定量———变化研究

本文旨在探讨慢性乙肝急性加重期患者自然恢复和短期抗病毒干预过程中的乙肝表面抗原（ＨＢ ｓＡｇ）定量变化。方法　选择２０１２年７月—２０１４年２月于我院诊断为乙型肝炎急性加重期的患者共７０例,随机 分为Ａ组和Ｂ组,每组３５例。Ａ组给予８周恩替卡韦抗病毒治疗,Ｂ组采取常规综合治疗。由专业医护人员分 别记录其ＨＢｓＡｇ定量结果、ＨＢＶＤＮＡ载量及终末期肝病模型（ｍｏｄｅｌｆｏｒｅｎｄ－ｓｔａｇｅｌｉｖｅｒｄｉｓｅａｓｅ,ＭＥＬＤ）评分。 两组患者在性别、年龄、住院天数及病程发展时间等方面无明显差异（Ｐ＞００５）,具有可比性。结果　Ａ组患者 极期及恢复期（４６±０９、３４±１１,ｌｏｇ１０ＩＵ／ｍｌ）比Ｂ组患者（５６±１５、４３±１４,ｌｏｇ１０ＩＵ／ｍｌ）的ＨＢＶＤＮＡ载 量高,其差异具有统计学意义（Ｐ＜００５）。两组ＭＥＬＤ评分、ＨＢｓＡｇ定量各期及ＨＢＶＤＮＡ载量入院期指标等均 无统计学差异（Ｐ值均＞００５）。在Ａ组中,患者ＨＢｓＡｇ定量结果在组内各期之间无统计学差异（Ｐ＞００５）,而 其ＨＢＶＤＮＡ载量处于下降趋势中,各期内的差异具有统计学意义（５９±１７、４６±０９、３４±１１,Ｐ＜００５）。 ＭＥＬＤ评分在入院时到极期改变无意义（Ｐ＞００５）,但在恢复期明显下降（１７５±５１、１９２±４９、７８±３６,Ｐ ＜００５）。Ｂ组患者的ＨＢｓＡｇ定量在组内各期无统计学意义（Ｐ＞００５）,ＨＢＶＤＮＡ载量及ＭＥＬＤ评分在病程初 期改变均无意义,而在恢复期明显下降,差异具有统计学意义（Ｐ＜００５）。结论　恩替卡韦等核苷类似物对患 者ＨＢＶＤＮＡ复制具有有效抑制作用,但对体内ＨＢｓＡｇ定量消除无明显积极作用。在短期使用抗病毒药过程 中,血清中ＨＢｓＡｇ水平不发生改变。     

糖尿病肾病患者血小板活性及血浆内皮素水平测定

为了解血小板活性及血浆内皮素１（ＥＴ１）水平在糖尿病肾病发生与发展中的作用，用放射免疫分析法与酶联免疫吸附分析法分别测定７８例不同程度糖尿病肾病患者血ＥＴ１和血小板α颗粒膜蛋白（ＧＭＰ１４０）、血栓素Ｂ２（ＴＸＢ２）及６酮前列环素Ｆ１α（６ＫｅｔｏＰＧＦ１α）含量。结果，糖尿病患者各组ＧＭＰ１４０与ＴＸＢ２水平分别高于对照组（Ｐ＜００５或Ｐ＜００１），肾功能不全组的ＧＭＰ１４０又高于其他肾病组（Ｐ＜００５）。糖尿病患者ＰＧＦ１α浓度则低于对照组（Ｐ＜００５），但肾病各组间比较无差异（Ｐ＞００５）。糖尿病肾病组各组ＥＴ１水平显著高于对照组（Ｐ＜００１或Ｐ＜０００１），且随肾病病变加重依次升高，各组间比较均有显著性差异（Ｐ＜００５）。结果提示：糖尿病肾病可能与血小板活性增高和血内皮素水平的升高导致肾脏血液动力学方面的改变，减少肾血流量，加重细胞缺血缺氧及直接刺激肾小球系膜细胞增生、肥大有关     

心脉龙治疗肺心病心衰的机制探讨

应用心脉龙注射液治疗肺心病心衰患者，探讨其作用机制．对６０例肺心病Ⅱ度心衰患者，随机分为对照组（地戈辛＋酚妥拉明，Ａ组），心脉龙治疗组（Ｂ组），用ＳＰＥＣＴ心血池动态显像术，观察其对右心室收缩、舒张功能、ＲＶＦＦ，１／３ＥＦ，ＲＶＰＦＲ，１／３ＦＦ及血浆ＥＴ，ＡＮＰ的影响．对比观察各组用药前后及两组间治疗后，右心室血液动力学效应，心脏内分泌变化．结果Ｂ组治疗后右心室收缩、舒张功能均有显著改善（Ｐ＜００５或Ｐ＜００１）的同时ＥＴ，ＡＮＰ亦随之显著降低（Ｐ＜００５或Ｐ＜００１）；Ｂ组与Ａ组比，治疗后心功能改善显著优于Ａ组（Ｐ＜００５或Ｐ＜００１）．结果表明心脉龙具有正性肌力作用，其扩张肺血管，降低肺动脉高压，改善右心室舒张功能的机制是拮抗ＥＴ．     

射频消融治疗频发室性早搏对左室功能及其结构的影响

目的 探讨射频消融治疗频发室性早搏（室早）对左室功能及其结构的影响。 方法 收集2006年1月至2010年12月成功行射频消融治疗的频发室早病例56例,同期随访未予射频消融治疗的频发室早病例42例。比较不同处理前、后室早数、超声心动图LVEF、LVEDD、LVESD、IVSd、LVPWd各参数的变化。 结果 ①与非消融组比较,消融组射频消融治疗后,室早总数明显减少（17813±1542个/24h）vs（125±113个/24h）,P<0.01;超声心动图[LVEDD（48.9±3.8）vs（44.1±4.0）,P<0.05;LVESD（30.1±4.2）vs（27±3.7）,P<0.05;IVSd（8.5±0.8）vs（7.5±0.8）,P<0.05;LVPWd（8.5±0.9）vs（7.5±0.8）,P<0.05]各项参数差异有显著性;LVEF[（0.64±0.08）vs (0.72±0.06),P<0.05]显著提高。②与术前比较,射频消融治疗后,室早总数由术前的（23662±12559个/24h）减少为（125±113个/24h）,P<0.01,患者胸闷、心悸症状缓解,超声心动图[LVEDD（50.6±5.4）vs（44.1±4.0）,P<0.05;LVESD（32.1±5.3）vs（27±3.7）,P<0.05;IVSd（8.8±1.1）vs（7.5±0.8）,P<0.05;LVPWd（8.7±1.1）vs（7.5±0.8）,P<0.05]各项参数明显缩小;LVEF[（0.64±0.09）vs (0.72±0.06),P<0.05]显著提高。 结论 射频消融可有效改善频发室早引起的心脏结构重构和功能减退,缓解患者不适症状。     

冠心病患者QT间期离散度与程序刺激诱发的室性心动过速相关性研究

目的 :探讨体表心电图QT间期离散度与冠心病患者程序刺激诱发的室性心动过速的关系。方法 :选择 4 0例接受心脏导管手术的患者 ,其中陈旧性心肌梗死患者 2 0例 ,阵发性室上性心动过速患者 2 0例。术前测定患者体表心电图QT间期离散度 ,术中在右心室起搏刺激以诱发持续室性心动过速 ,探讨QT间期离散度与室性心律失常之间的关系。结果 :2 0例陈旧性心肌梗死患者共有 6例诱发出持续室性心动过速 ,2 0例阵发性室上性心动过速患者中无 1例诱发出持续室性心动过速。冠心病患者体表心电图QT间期离散度较阵发性室上速患者明显增大 (85 .7± 2 4 .6msvs 34.8± 11.3ms,P <0 .0 1) ;冠心病患者中诱发出持续室性心动过速者 ,其QT间期离散度较未诱发出持续室性心动过速者亦明显增大 (98.7± 5 6 .2msvs 70 .4± 2 8.5ms,P <0 .0 5 )。取QT间期离散度≥ 110ms,对室性心律失常的预测有一定价值。结论 :体表心电图QT间期离散度与冠心病患者室性心律失常具有相关性 ,取QTd≥ 110ms对室性心律失常有一定的预测价值。     

Experience on application of transveneous implantable MINI Ⅱ cardioverterdefibrillator for ventricular tachycardia due to right ventricular dysplasia:a report of a case

Theimplantablecardioverterdefibrillator(ICD)therapyhasbecomeanimportantmethodfortreatingmalignantventrlculartachyarrhythmiasatpresent.ThisreportdealswithourPrimaryexperienceinclinicalapplicationoftransveneousimplantablecardioverterdeflbrlllator.CLINICALMATERIALSA43--year--oldmalepatientadmittedtohospitalonoctober10.1997becauseofparoxymalventrlculartachycardla(VT).HecomplainedofsufferingVTasmanyas6timesduring2years.TherateofVTwas110to180bpm.In:3times.V'YcouldnotbeterminatedbyInject…     

Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

Background Cardiac resynchronization therapy （CRT） could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure （HF） with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT（D） device, aged （57±11） years, with left ventricular ejection fraction of （32.1±9.8）%, of which 4 （7%） developed ventricular tachycardia/ventricular fibrillation （VT/VF） or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient＇s death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.     

特发性右室流出道室速的昼夜发作规律及临床意义

目的：探讨特发性右室流出道室速的昼夜发作规律及临床意义,方法：对12例特发性右室流出道室速患者在基础状态进行动态心电图（Holter)监测,分别记录24h中每小时内心律失常发作频数及平均心率,了解室速,室早发作的昼夜规律,结果：基础状态下,室速,连发室早,平均心率在24h内呈不均一分布（P＜0．001）,其发作规律呈白天多,夜间少,单个室呈不均一分布,但整个差异无显著性,平均心率与室速,连发室早互正相关,单个室早与平均心率无相关性,结论：左室流出道室速患者24h内室速,连发病早呈明显的昼夜节律变化,提示特发性右室流出道室速的发生与交感迷走神经平衡失调有关。     

QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

［1］Richardson CP, Mckenna RM, Bristow CM, et al.Report of the 1995 Word Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996,93: 841 ［2］Barr CS, Naas A, Freeman M, et al. QT dispersion and sudden unexpected death in chronic heart failure. Lancet, 1994,343:327 ［3］Martin AB, Garson A, Perry JC, et al. Prolonged QT interval in hypertropic and dilated cardiomyopathy in children. Am Heart J, 1994,127(1):64 ［4］Pye M, Quinn AC, Cobble SM. QT dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?Br Heart J, 1994,71(5):51 ［5］Berger RD, Kasper EK, Baughman KL, et al. Beat to beat QT interval variability: novel evidence for repolarization lability in ischemic and non ischemic dilated cardiomyopathy. Circulation, 1997, 96 (5):1557 ［6］Wolfram G, Ulrike S, Volker M, et al. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol, 1997,78: 458 ［7］Fei L, Goldman JH, Prasal K, et al. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur Heart J, 1996,17: 258 ［8］Pan YZ, Guo NS, Xing ZF, et al. The relation between QT dispersion and ventricular arrhythmia of dilated cardiomyopathy. Chin J Inter Medi, 1996,35(11):73 ［9］Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J, 1998,19(7) :1054     

儿童室性心动过速生存率及预后影响因素的分析

目的分析儿童室性心动过速 (VT)生存率及影响预后的因素。　方法对 1993年 2月至 2 0 0 2年 12月资料完整的 32例VT患者进行随访 ,用Kaplan -Meier法行生存分析。　结果 32例VT存活 2 0例 ,死亡 12例。VT后生存曲线逐月下降 ,2周 ,2、6、12月生存率分别为 71.8%、6 8.8%、6 5 .6 %、6 2 .5 %。患病年龄、原发心脏疾病、合并心功能衰竭、持续性VT、多形VT、药物治疗效果在死亡与存活患儿之间有显著差异 (P <0 .0 1)。　结论伴严重器质性心脏病、合并心功能衰竭、持续性VT、多形VT、药物治疗无效是影响预后的危险因素 ,有必要对VT患者长期随访     

Clinical study of 39 Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy

Background There are few studies on the clinical profile of Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy （ARVD/C）. The purpose of this study was to describe the clinical characteristics of ARVD/C patients from China, particularly to define the features of electrocardiograph and treatment outcomes.
Methods Thirty-nine patients hospitalized in Fu Wai Cardiovascular Hospital from 1998 to 2006 were included. The data were obtained from the medical archive and the follow-up records.
Results Of these patients 33 were male and 6 female （age at the first presentation was （34.9 ± 9.8） years）. The most common symptoms were palpitation （62%） and syncope （44%）. Right precordial QRSd 〉 110 ms was detected in 69% of the patients, epsilon wave in 59%, and a ratio of QRSd in V1＋V2＋V3/V4＋V5＋V6 ≥ 1.2 in 82%. The most frequent features of electrocardiogram in patients without right bundle-branch block were T-wave inversions and S-wave upstroke in V1-V3 〉55 ms （96% and 90% of 28 patients, respectively）. Radiofrequency catheter ablation （RFCA） for ventricular tachycardia （VT） was successful in 15 （68%） of 22 patients. The recurrence rate of VT was 46% （7/15） during the follow-up of （16.7 ± 11.2） months. Seven patients had cardioverter/defibrillator （ICD） implanted plus drug therapy and 17 patients took antiarrhythmic drugs alone. During the follow-up of （35.6 ± 19.0） months, all patients with ICD implanted received at least one appropriate ICD shock. One patient died of ventricular fibrillation suddenly and one patient underwent heart transplantation for progressive biventricular heart failure during the drug therapy alone.
Conclusions This study demonstrated the clinical and ECG features of the 39 ARVD/C Chinese patients. ICD provided life-saving protection by effectively terminating malignant arrhythmias, and the high recurrence of VT was the major problem of RFCA therapy.     

QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

Objective To evaluate the clinical significance of QT dis persion (QTd, QTcd) in dilated cardiomyopathy (DCM). Methods QTd and QTcd were measured on simultaneously recording 12-lead electrocardiograms ( ECGs) in 60 DCM patients and cormpared with 60 healthy subjects. Results The values of QTd and QTcd in DCM were significantly higher than those in control group ( P ＜ 0. 01 ). With subgroup analysis, QTd and QTcd in patients uith cardiac sudden death (CSD) were longer than those in survivors and those died of progressive heart failure ( P ＜ 0. 05), patients with ventricular tachycardia (VT) or with severe heart failure than those without (compared uith patients with ventricular premature beats [V PB], P＜0.05, compared with patients without ventricular arrhythmia [VA], P＜0. 01) or with mild heart failure (P＜0. 01). The values of QTd and QTcd in patients with VPB were greater than those in patients without VA( P＜ 0. 05). There were significant differences in the rates of VT, CSD and heart failure between the groups of QTd＞ 110 ms and QTd≤110 ms(P＜0. 01 or P＜0.05), in contrast to ejection fraction (EF) and fractional shortening (FS)( P＞0.05). Conclusion The values of QTd and QTcd increased in DCM patients were susceptive index for monitoring maligant VA in DCM, also important prognostic markers of CSD. QTd was correlated with NY HA functional class but not with EF and FS.     

频域法检测心室晚电位临床应用初探

本文利用计算机信号平均技术及频谱估计方法对110人从体表检测心室晚电位。59个正常人中仅1例发现晚电位,阳性率为1.7％,心肌梗塞未并发室性心律失常患者24例中20.8％(5/24)有晚电位;心肌梗塞并发室性心律失常5例病人中80％(4/5)有晚电位。下壁梗塞者晚电位阳性率47.06％,高于其它部位梗塞者(8.33％)。室性早搏组及非持续性室速患者晚电位阳性率分别为30％(3/10)和38.46(5/13),而持续性室速患者阳性率高达100％(4/4)。研究结果表明:(1)心室晚电位与室性心律失常,特别是持续性室速有密切关系;(2)频阈法体表检测晚电位可能成为辨识心肌梗塞后有严重室性心律失常倾向病人的一种无创方法。