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目的了解慢型克山病猝死前的VCG变化,为克山病的防治研究提供有价值的信息。方法应用VCG对慢型克山病进行检查,追踪观察3~12个月内猝死的慢型克山病患者的VCG变化。结果QRS环蚀缺的总检出率为87%,QRS环形态呈麻花形,不规则形、“8”形的总检出率为100%,T环呈小圆形、不规则形、“△”的总检出率为100%。60.9%的病人的QRS环最大角度在Sr面大于+140°,在H面超过-20°,65.2%的病人的QRS环最大电压在Sr、H面分别大于1.45 mV和1.62 mV。呈CRBBB和CRBBB合并LAB的为26.1%。T环电压明显小的总检出率为56.5%,T/R值明显小的总检出率为60.9%,S-T向量大于正常的总检出率为60.9%,QRS-T角增大的检出率为100%。结论猝死前的慢型克山病的VCG表现多数为QRS环有一处~三处的蚀缺,形态呈麻花性、不规则形和“8”字形,多数病人的QRS环最大角度明显的向后下和左后偏移,Sr、H面的QRS环最大电压明显增大,有束支传导阻滞者其最大角度不固定,其电压和环体可大可小,但运行时间是缓慢和密集的,T环的形态多数呈小圆形、不规则形和“△”,多数病人的T环电压明显缩小,有的几乎看不到T环,多数病人可检出增大的S-T向量的电压,QRS-T角明显增大,多数在180°。
Objective To understand the changes of VCG before the sudden death of chronic Keshan disease and provide valuable information for the prevention and treatment of Keshan disease. Methods The chronic Keshan disease was examined by VCG, and the changes of VCG in patients with chronic Keshan disease who died within 3 to 12 months were observed. Results The total detection rate of QRS ring eclipse was 87%. The shape of QRS ring was cannulous and irregular. The total detection rate of “8” was 100%. The T ring was small and irregular. △ “the total detection rate of 100%. The maximum QRS ring angle of 60.9% patients was greater than + 140 ° on the Sr side and more than -20 ° on the H side. The maximum QRS ring voltage of 65.2% was greater than 1.45 mV and 1.62 mV on the Sr and H sides, respectively. 26.1% for LAB combined with CRBBB and CRBBB. The detection rate of T-ring voltage was 56.5%, the detection rate of T / R was 60.9%, the detection rate of ST vector was 60.9%, the QRS-T angle was increased The rate is 100%. Conclusions Most of the patients with chronic Kerstan disease before sudden death have VCGs with one or three erosions in the QRS ring. The shapes of the QRS rings are twisty, irregular and ”8“ Under and left shift, the maximal QRS ring voltage of Sr and H planes obviously increases. The maximum angle of bundle branch block is not fixed, and the voltage and ring body may be smaller or smaller, but the running time is slow and dense , The majority of T-ring morphology was small round, irregular and ”△", the majority of patients with T-ring voltage was significantly reduced, and almost do not see the T-ring, most patients can detect increased ST vector voltage , QRS-T angle increased significantly, the majority at 180 °.