天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (8): 856-860.doi: 10.11958/20210731

• 临床研究 • 上一篇    下一篇

儿童先天性漏斗胸胸廓畸形与心电图异常的关系

王庆峰，王新康△   

  1. 福建医科大学省立临床医学院/福建省立医院心电诊断科（邮编350001）
  • 收稿日期:2021-03-29 修回日期:2021-05-19 出版日期:2021-08-15 发布日期:2021-08-19
  • 通讯作者: 王庆峰 E-mail:fjydqingfeng@163.com
  • 作者简介:王庆峰（1992），男，硕士，住院医师，主要从事心脏电生理及心电诊断研究。E-mail：fjydqingfeng@163.com
  • 基金资助:
    国家自然科学基金面上项目（61971140）

Relationship between chest wall deformity with congenital pectus excavatum and abnormal electrocardiogram in children

WANG Qing-feng, WANG Xin-kang△   

  1. Department of Electrocardiographic Diagnosis, Fujian Provincial Hospital, Provincial Clinical Medicine College of Fujian Medical University, Fuzhou 350001, China △Corresponding Author E-mail: 2891666356@qq.com
  • Received:2021-03-29 Revised:2021-05-19 Published:2021-08-15 Online:2021-08-19

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摘要： 目的 探讨儿童先天性漏斗胸（PE）胸廓畸形与心电图（ECG）异常的关系。方法 选取符合PE诊断的患 儿65例为PE组，选取性别、年龄与之匹配的65例健康体检儿童为对照组，比较2组ECG特征差异。65例PE患儿根 据是否合并左心房异常、是否合并不完全性右束支传导阻滞（IRBBB）以及是否合并电轴右偏分成不同亚组，比较各 组一般资料、Haller指数和心脏旋转角差异。测量PE患儿的V1导联P波负向波振幅，采用Spearman秩相关分析评估 V1导联P波负向波的振幅与Haller指数、心脏旋转角的相关性。结果 PE组IRBBB、电轴右偏、Ptf-V1≤-0.04 mm·s 及左心房异常比例高于对照组，P波负向波振幅大于对照组（P＜0.05）。左心房异常组的心脏旋转角和Haller指数均 大于无左心房异常组（P＜0.01）。IRBBB组Haller指数和心脏旋转角大于无IRBBB组（P＜0.01）。电轴右偏组与无 电轴右偏组的Haller指数和心脏旋转角差异均无统计学意义。PE患儿的V1导联P波负向波振幅分别和Haller指 数、心脏旋转角呈正相关（rs分别为0.573和0.658，P＜0.01）。结论 儿童PE心电图常见左心房异常、IRBBB、电轴右 偏。异常心电图对PE的胸廓畸形评估有应用价值。

关键词: 漏斗胸, 心电描记术, 胸廓, 儿童, Haller指数

Abstract: Objective To investigate the relationship between chest wall deformity with congenital pectus excavatum (PE) and abnormal electrocardiogram (ECG) in children. Methods Sixty-five children who met the PE standard were selected as the case group, and 65 healthy children matched in gender and age in the same period were selected as the control group. Sixty-five PE children were divided into subgroups according to whether they had left atrial abnormality or right axis deviation or incomplete right bundle branch block (IRBBB). The general data, Haller index and the differences of cardiac rotation angle were compared between different groups. The amplitude of negative P wave in lead V1 was measured in children with PE. Spearman correlation analysis was performed to estimate the correlation between the amplitude of negative P wave in lead V1 and Haller index, and the correlation between the amplitude of negative P wave in lead V1 and cardiac rotation angle. Results The proportion of left atrial abnormality, IRBBB and right axis deviation was significantly higher in the PE group than that in the control group (P＜0.05). The amplitude of negative P wave in V1 lead was larger in the PE group than that in the control group (P＜0.01). The cardiac rotation angle and Haller index were higher in the left atrial abnormality group than those in the non-left atrial abnormality group (P＜0.01). The cardiac rotation angle and Haller index were higher in the IRBBB group than those in the non-IRBBB group (P＜0.01). However, there were no significant differences in cardiac rotation angle and Haller index between the right axis deviation group and the non-axis right deviation group. In addition, the amplitude of negative P wave in lead V1 was positively correlated with Haller index and cardiac rotation angle in children with PE (rs=0.573 and 0.658 respectively, P＜0.01). Conclusion Left atrial abnormality, IRBBB and right axis deviation are common in children with PE. The abnormal ECG has the practical value in the evaluation of chest wall deformity in PE.

Key words: funnel chest, electrocardiography, thoracica, child, Haller index

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