早期复极综合征心电图变化特点及鉴别诊断.docVIP

早期复极综合征心电图变化特点及鉴别诊断【摘要】目的分析早期复极综合征(ERS)的心电图变化特点，探讨其临床意义及鉴别诊断。方法对80例ERS的心电图及临床资料进行回顾分析。结果ERS以男性多见(85％)。ST抬高及高耸T波改变以V3V5导联最为明显，大多伴J波，STT改变较恒定，运动试验可使ST段暂时回落至基线。结论ERS是以J波和STT改变为主要表现的心电图综合征，但易与有类似心电图表现的器质性心脏病相混淆。 【关键词】早期复极综合征；心电图变化；运动试验；鉴别诊断 EARLY REPOLARIZATION SYNDROME FEATURES AND DIFFERENTIAL DIAGNOSIS OF ECG CHANGESLIU Jiayan Lechang City, Guangdong Province, the First Peoples Hospital,Lechang 512200,China 【Abstract】ObjectiveTo analyze the early repolarization syndrome (ERS) of the characteristic ECG changes Its clinical significance and differential diagnosis Methods80 cases of ERSs ECG and clinical data were retrospectively analyzed ERS results to male patients (85%) ST elevation and tall T wave changes in leads V3V5 the most obvious, most of them with J wave, STT changes relatively constant, exercise testing can temporarily dropped to the baseline ST segment ConclusionERS is J wave and STT changes in ECG syndrome as the main performance, but easy with a similar ECG confused with organic heart disease.ResultsERS is a biological variation of the ECG, the majority of asymptomatic, part of the performance of chest pain, chest tightness, heart palpitations based, while the ECG showed STsegment elevation, T wave tall, exactly like the ultraacute myocardial infarction, variant angina and structural heart disease such as acute pericarditis, graphics, often clinically misdiagnosed ［1］To explore the differential diagnosis, now admitted to our hospital in the past few years 80 cases of ERS analyzed. 【Key words】Early repolarization syndrome; ECG changes; Exercise test;Differential diagnosis 作者单位：512200广东省乐昌市第一人民医院心电图室ERS是一种生理变异的心电图表现，多数无症状，部分表现以胸痛、胸闷、心悸为主，而心电图表现为ST段抬高，T波高耸，酷似超急性心肌梗死、变异型心绞痛和急性心包炎等器质性心脏病的图形，临床上常易误诊［1］。为探讨其鉴别诊断，现将我院这几年收治的80例ERS进行总结分析。 1资料与方法 11一般资料回顾性分析我院 2008年8月至2012年8月住院、门诊患者以及健康体检确诊为ERS者80例，其中男68例，女12例 (其中男性占85%)。年龄16～60岁。有高血压10例；以心前区疼痛、胸闷不适症状就诊者20例，包括心悸、胸闷、心前区隐痛等,其中心电图首次诊断疑似心肌梗死4例，变异型心绞痛6例；全部病例分别经临床病史、心肌标记物、心电图追踪、运动试验、超声心动图、