气胸致心电图变化及其机制探讨  

The ECG Change and Its Mechanism in Pneumothorax

作　　者：肖斌[1] 任江华[2] 许喜泳[1] 

机构地区：[1]武汉大学中南医院急诊科,武汉430071 [2]武汉大学中南医院心内科,武汉430071

出　　处：《医学新知》2004年第3期167-169,共3页New Medicine

摘　　要：目的　探讨气胸致ECG变化的特点及可能的机制。方法　将病例分为左侧气胸组和右侧气胸组 ,在气胸急性期用 12导ECG自动分析仪描记ECG ,并测量各导联QRS波群振幅。结果　同右侧相比 ,左侧气胸组QRS波群振幅以V1最大 ,并从V2 ～V6逐渐减小 ,在V3 ～V6出现低电压。两组Rv5/Sv1比值 (P <0 .0 0 1)及钟向转位 (P <0 .0 5 )有显著性差异。左侧气胸组中V1及Rv1的振幅与气胸量呈直线相关 (r=0 .35 6P <0 .0 5 ;r=0 .373P <0 .0 5 ) ,其余导联及右侧气胸各导联振幅与气胸量无相关性 (P >0 .0 5 )。结论　左侧气胸时 ,心脏和前胸壁之间的空气阻碍了左侧胸导联 (V3 ～V6)的心电活动向体表的传导 ,其振幅减小程度与气胸量无关。而V1与Sv1振幅的大小与气胸量呈正相关。左侧气胸导致的心脏顺时钟转位 ,可能也参与了上述过程的形成。Objective To investigate the characteristics of the ECG change and its mechanism caused by pneumothorax.Methods The patients were divided into left pneumothorax group and right pneumothorax group and ECG was measured by 12-lead ECG autoanalyser in the acute period of pnumothorax.Results The amplitude of QRS pattern is highest in lead V1 and then declines gradually from V_2 to V_6 and the hypovoltage occurred from V_3 to V_6 in the group of left pneumothorax in comparison with that of the right. There is significant difference in the ratio of Rv_5/Sv_1 (P<0.001) and the heart clockwise transposition (P<0.05) between the two groups. The amplitude of V_1 and Rv_1(r=0.356 P<0.05;r=0.373 P<0.05) in the left pnumothorax group has linear correlation with air volume in the thorax but no correlation with other leads (P>0.05).Conclusion The conductance of ECG of the left chest leads (V_3～V_6) to body surface is impeded by the air between the heart and the front thoracic wall in the left pneumothorax, but there is no relationship between the change of ECG and air volume. However, the amplitude of V_1 and Rv_1 has positive correlation with air volume. The heart clockwise transposition caused by the left pneumothorax may also play an important role in the ECG change.

关 键 词：气胸 左侧 心电图 机制探讨 ECG QRS波群 心脏 转位 变化 自动分析仪 

分 类 号：R561[医药卫生—呼吸系统]