12导动态心电图与12导常规心电图各项心电参数差别的研究  

STUDY ON DIFFERENCE OF EACH ELECTROCARDIAC PARAMETER OF 12 LEADS DYNAMIC ELECTROCARDIOGRAM AND 12 LEADS ROUTINE ELECTROCARDIOGRAM

作　　者：黄宝晨[1] 高淑梅[1] 张钧[1] 李民[1] 王竹君[1] 邢耀太[1] 

机构地区：[1]承德医学院附属医院

出　　处：《现代电生理学杂志》2005年第4期201-203,共3页Journal of Modern Electrophysiology

摘　　要：目的：探讨12导动态心电图与12导常规心电图各项心电参数的差别,为提出12导动态心电图(DECG)的诊断标准提供依据。方法：用常规12导心电图(RECG)的连接方式和12导动态心电图的连接方式分别描记心电图,然后比较两种连接方式心电图各项心电参数的差别。结果：两种连接方式心电参数的差别主要有：①P波一致率为94.5％,两种心电图的差别为,DECG导联P波电压比RECG导联P波电压增高的24例(4％)。②QRS波群：胸前导联形态一致率为96％,在肢体导联一致率为11％,Ⅰ、avL、Ⅲ导联形态不一致率分别为31.5％、41.1％、25.6％。Ⅱ、avR、avF导联QRS形态一致率为87.6％,但DECG导联QRS波群电压大于RECG导联1.2～2.5倍。③ST-T：ST段两者一致率为92.5％,T波两者的一致率为94.8％。④心电轴：两种心电轴都在正常范围的共246例(62％),完全相同的仅为6.7％,主要差别为DECG导联比RECG导联心电轴右移+3～+90°,平均为+17.5°。结论：①两种连接方式(DECG和RECG)QRS波群形态在胸前导联的一致率为94％,因此,两种心电图诊断除分支阻滞以外的心律失常可用同一标准。②由于两种心电图差异较大,所以,DECG不能用RECG标准诊断分支阻滞。③ST-T改变一致率为92.5％以上,可以用同一标准判断。④两方法的QRS波群电压差别较大,DECG诊断心室肥大不能用RECG诊断标准,应重新制定新的诊断标准。⑤两种导联的P波一致率为94.5％。DECG在诊断心房肥大时可适当参照RECG标准。Objective： To explore the difference of 12 leads dynamic electrocardiogram （DECG） and 12 leads routine electrocardiogram （RECG） in each parameter of electrocardiogram （ECG）. Methods： The ECG was done separately with DECG and RECG. Then, difference of each parameter of DECG and RECG was compared. Results： The main difference of parameter of the two methodes was as follows： （ 1 ） The consistent rate of P wave is 94.5%. In the voltage of P wave DECG, is higher than that of RECG in 24 cases （4%）. （2） In QRS wave, the consistent rate in thorax leads is 96%, the consistent rate in limbs leads is 11% , the inconsistent rate in I avL and Ⅲ leads separately are 31.5% 41.1% and 25.6% , the consistent rate in Ⅱ avR and avF leads separately is 87.6%. But on voltage of QRS, DECG is 1.2 2.5 times of RECG. （3） In ST-T： the consistent rate of ST 92.5%, the consistent rate ofT wave is 94.8%. （4） In eleectrocardiac axis, 246 cases are normal in both, Only 6.7% is just the same in both. the main difference is that DECG electrocardiac axis moves ＋3° - ＋90° to the right, average is ＋ 17.5°, than that of RECG. Conclusions： （1） The consistent rate of QRS wave in DECG and RECG is 94% in thorax lends. Therefore, diagnosis of arrythmias may use same standard in both, except branch block.（2） Because the greater difference of both methods DECG standard can＇nt be used to diagnose branch block. （3） The consistent rate of ST -T changes is 92. 5%. The same standard can be used for judgement. （4） The difference of the voltage of QRS wave is greater in DECG and RECG. The diagnostic standard of RECG can＇t de used to diagnose the hypertrophy of the ventricle in DECG. New diagnostic standards should be stipulated. （5） The consistent rate of P wave is 94.5% in both methods. RECG standard can be referred in diagnosis of auricular hypertrophy.

关 键 词：12导动态心电图 心电图 导联 标准 参数 

分 类 号：R540.41[医药卫生—心血管疾病] R541.4[医药卫生—内科学]