完全性左束支阻滞的临床意义探讨

目的：探讨完全性左束支阻滞（complete left bundle branch block,CLBBB）的临床意义。方法：对常规心电图检查为CLBBB的162例住院患者的动态心电图、超声心动图及冠状动脉造影检查结果进行回顾性分析。结果：动态心电图显示：97例患者合并各种类型心律失常。超声心动图显示：111例发生不同程度左房、左室肥大及心脏瓣膜病变,左室射血分数（LVEF）≤50%者80例。37例冠脉造影显示：以左前降支为主的单支及多支病变16例。结论：CLBBB多发生于老年患者,常见于器质性心脏病,主要为高血压、冠心病、退行性心脏瓣膜病、扩张性心肌病等,且多伴发各种类型心律失常,易导致心功能不全。临床应对CLBBB尤其是新发的CLBBB患者进行动态心电图及超声心动图评估,必要时行冠脉造影及心脏电生理检查以明确原因,及时采取治疗措施。

EXPLORATION OF THE CLINICAL SIGNIFICANCE ON PATIENTS WITH COMPLETE LEFT BUNDLE BRANCH BLOCK

Objective： To explore the clinical significance of complete left bundle branch block （CLBBB）. Methods： The results of dynamic electrocardiogram,echocardiography and coronary arteriography examination of 162 hospitalized patients with CLBBB showed by routine electrocardiogram were analyzed retrospectively. Results：Dynamic electrocardiogram showed that 97 patients were complicated with all kinds of arrhythmia. Echocardiography showed that 111 cases had different degree of left atrial and left ventricular hypertrophy and heart valve disease,and left ventricular ejection fraction（LVEF）was less than 50% in 80 cases. The coronary angiography of 37 cases showed that lesions of one or many branch in left anterior descending branch in 16 patients. Conclusion：CLBBB was more common in older patients with organic heart disease. They were mainly hypertension,coronary heart disease,degenerative valvular heart disease,dilated cardiomyopathy, etc,and often complicated with all kinds of arrhythmia and cardial dysfunction. All patients with CLBBB especially for new ones should be given dynamic electrocardiogram and echocardiography examination. If neccesarry, coronary arteriography and electrophysiological examination should be used to confirm the etiology. The effectivetrea tment should be taken timely.