“半模拟”12导联与常规12导联心电图各波段比较的实验研究  

Investigation of the difference and relationship between ″semi-mock″ 12-lead ECG and routine 12-lead ECG

作　　者：查春光[1] 俞国华[2] 汤俐文[1] 袁励[1] 张永军[1] 徐尚银[1] 徐舒[1] 鲁其乐[1] 叶艇[1] 

机构地区：[1]皖南医学院弋矶山医院心功能科,241001 [2]皖南医学院弋矶山医院心内科,241001

出　　处：《临床心电学杂志》2005年第3期183-187,共5页Journal of Clinical Electrocardiology

摘　　要：目的观察分析“半模拟”12导联与常规12导联心电图的异同之处,为12导联动态心电图诊断标准提供依据。方法比较200例正常人采用“半模拟”12导联及常规12导联记录的心电图各波段。结果“半模拟”12导联心电图无论是平卧位还是直立位,P波的形态、方向均几乎与常规一致,P波振幅普遍较常规增高,有8%的人直立位时表现为“肺型”P波;QRS波的形态在胸导联Vl～V6及肢导联aVR与常规相似;在“半模拟”Ⅲ、aVF导联ST段表现与常规符合率较低穴81.5～88%雪,其余导联的符合率较高,>90%。有少数受检者部分导联ST段压低≥0.05mV,无一例超过0.1mV。T波在平卧位“半模拟”Ⅰ、Ⅱ、V1～V6导联与常规导联符合率较高,为99%～100%;“半模拟”12导联未见异常U波出现。结论如果采用常规心电图诊断标准,ST段压低超过0.1mV有病理意义的可能性大,胸导联QRS波形较肢导联QRS波形对室性心律失常定位较准确,出现异常U波有病理意义。“半模拟”12导联心电图表现的左室肥大、右室肥大、异常深Q波不可轻率诊断。Objective To analyze the difference and relationship between ＂semi-mock＂ 12-lead electrocardiogram（SMECG） and routine 12 -lead electrocardiogram（RECG） . Methods 200 healthy subjects underwent examination with SMECG and RECG, then all the SMECG and RECG were analyzed. Results In SMECG, whether subjects were in lying on its back or up-right position P waves were almost identical with that in RECG except that the amplitudes of P wave were higher generally,of which,8% showed peaked P wave; QRS wave in chest leads V1～V6 and limb lead aVR were similar to that in RECG, but in other leads, QRS waves were notebly different from that in rout RECG;STm and STaVF in SMECG were partly identical with RECG （81.5%-88%）. ST in other leads was almost same in both of ECG, mininory subjects had ST≥0.05mV depression in part of leads, but no subject had ST〉0.1mV depression,T wave in semi-mock Ⅰ , Ⅱ , V1～V6 leads were almost identical with that in routine ECG,and no abnomal U wave was seen in semi-mock ECG. Conclusion In term of RECG diagnosing criterion,semi-mock ECG has greater accuracy to judge the originary site of P wave, rising P wave is help to differentiate supraventricular arrhythnica from ventricular arrhythmia. ST segment depression lower than 0.1mV implies pathologenic lesion. QRS wave in chest leads has greater accuracy in judging site of ventricular arrhythmia than in judging site of ventricular arrhythmia than fin limb leads,and abnormal U wave implies pathologenic change. But SMECG has higher fake positive rate in judging left ang right ventricle enlargement, as well as abnormal deep Q wave. Such as 12-lead Molter uses in clinical.

关 键 词：“半模拟” 12导联心电图 常规12导联心电图 12导联动态心电图 

分 类 号：R540.4[医药卫生—心血管疾病]