刘奇英

[摘要] 目的 探讨完全性左束支传导阻滞与心脏结构功能改变及冠状动脉病变的关系。 方法 方便选取2018年1月—2019年8月来该院进行心电图检查诊断完全性左束支传导阻滞表现的患者116例。入组患者均进行冠状动脉CT血管造影（CTA）检查及心脏彩色多普勒血流显像仪检查，比较冠脉病变和冠脉正常检出率以及心脏结构功能改变与心脏功能结构正常检出率。结果 冠脉病变的检出率为81.9%（95/116），明显高于冠脉正常的检出率18.1%，差异有统计学意义（χ2=81.409，P=0.000）;在冠心病组、冠脉硬化组、冠脉正常组中，心脏结构功能改变的检出率[（89.1% vs 10.9%）、（82.5% vs 17.5%）、（85.7% vs 14.3%）]均高于心脏结构功能正常的检出率，差异有统计学意义（P<0.05）。结论 心电图表现完全性左束支传导阻滞有很大可能预示着冠状动脉病变以及心脏功能结构改变，应及时采取进一步的诊治措施。

[关键词] 心电图;完全性左束支传导阻滞;冠心病;心脏结构功能;冠脉硬化

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0193-03

Study on the Relationship between Complete Left Bundle Branch Block and Changes in Cardiac Structural Function and Coronary Artery Disease

LIU Qi-ying

Department of Electrocardiography， Meizhou People's Hospital， Meizhou， Guangdong Province， 514031 China

[Abstract] Objective To investigate the relationship between complete left bundle branch block and changes in cardiac structural function and coronary artery disease. Methods From January 2018 to August 2019， 116 patients who underwent ECG diagnosis of complete left bundle branch block in the hospital were convenienty selected. All patients underwent coronary CT angiography （CTA） examination and cardiac color Doppler blood flow imaging examination to compare the detection rate of coronary lesions and normal coronary arteries， as well as changes in cardiac structural function and normal detection rate of cardiac functional structure. Results The detection rate of coronary artery disease was 81.9% （95/116）， which was significantly higher than the normal detection rate of 18.1%. The difference was statistically significant （χ2=81.409， P=0.000）; the detection rate of changes in cardiac structural function in the coronary heart disease group， the coronary artery sclerosis group and normal coronary artery group [（89.1% vs. 10.9%）， （82.5% vs. 17.5%）， （85.7% vs. 14.3%）] were all high. There was a statistically significant difference in the detection rate of normal cardiac structural function （P<0.05）. Conclusion Complete left bundle branch block in electrocardiogram is very likely to predict coronary artery disease and changes in cardiac functional structure， and further diagnosis and treatment measures should be taken in time.

[Key words] Electrocardiogram; Complete left bundle branch block; Coronary heart disease; Cardiac structural function; Coronary sclerosis

完全性左束支傳导阻滞（complete left bundle branch block，CLBBB）往往意味着室内传导系统受损较大[1]，心电图显示CLBBB常预示心脏病变的可能，如冠心病、冠脉硬化、心衰、心肌病、心肌炎等，相比较完全性右束支传导阻滞（complete right bundle branch block，CRBBB）而言，CLBBB较少见于健康人群，且往往预后较差[2-3]。有学者提出，左束支的血供比较丰富，一般不会轻易发生完全性传导阻滞，一旦发生CLBBB，则常提示合并器质性心脏病[4]。因此，对于临床上心电图提示CLBBB出现的患者应当给予重视，并进一步检查诊断。该文以2018年1月—2019年8月该院诊治的116例有CLBBB表现的患者为研究对象，探讨CLBBB与心脏结构功能改变及冠状动脉病变的关系，报道如下。

1  资料与方法

1.1  一般资料

方便选取来该院进行心电图检查诊断CLBBB表现并接受冠状动脉CT血管造影（CTA）及心脏彩色多普勒血流显像仪检查的患者116例。……