正常人额面QRS电轴的年龄趋势以及对肢体导联QRS波振幅的影响  

Age trend of the frontal QRS axis in a normal population and its effect on QRS-wave amplitude in the limb leads

作　　者：吴杰[1] Jan A Kors Peter R Rijnbeek Gerard van Herpen 徐春芳[1] 陆再英 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,武汉430030 [2]荷兰Erasmus 大学医学信息研究所

出　　处：《中华心律失常学杂志》2006年第3期212-214,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的调查和评估正常人额面QRS电轴的年龄趋势以及对肢体导联QRS波振幅的影响。方法采集5360例(男性3614例、女性1746例,年龄范围18～84岁)正常健康人12导联心电图分为5个年龄组,计算和分析各年龄组额面QRS电轴的中位数以及肢体导联QRS波振幅的中位数和96%的正常范围上、下限。结果随年龄增长,男、女额面QRS中位数电轴一致性地逐渐向左(上)偏移大约27°(从70°偏移到43°,P＜0．001)。Ⅰ和aVL导联的R波振幅随年龄增长显著增加(P＜0．001),而下壁导联Ⅱ、Ⅲ和aVF的R波振幅随年龄增长显著降低(P＞0．001)。肢体导联R波振幅随年龄的变化趋势与额面QRS电轴的年龄趋势相一致。结论正常人额面QRS电轴随年龄增长逐渐向左(上)偏移,呈现明确的年龄趋势。QRS电轴的生理性演变可引起肢体导联QRS波振幅呈现明显的年龄差异。显然,把一个相同的左心室肥大心电图诊断标准应用到不同年龄组人群是不合适的。Objective To investigate the age trend of the frontal QRS axis in a normal population and its effect on QRS-wave amplitude in the limb leads. Methods Standard 12-lead ECGs from 5 360 appparently healthy Chinese subjects （3 614 men and 1 746 women, ages ranging from 18 to 84 years）were collected with a modern digital recorder and processed with a well-validated ECG computer program. The median, lower limits （2nd percentile）and upper limits （98th percentile）of the frontal QRS axis and QRS amplitude measurements were calculated and age trend examined. Results Median QRS axis gradually shifted to the left by about 27° with increasing age for both sexes（ P 〈0. 001 ）. R-wave amplitude in leads Ⅰ and aVL increased with age（ P 〈 0. 001 ）. Conversely, R-wave amplitude in the inferior leads Ⅱ, Ⅲ and aVF consistently decreased with increasing age（ P 〈 0. 001 ）. These QRS-wave changes in the limb leads were concomitant with a frontal QRS axis shift to the left with age. Conclusions The frontal QRS axis in a normal population shows significant age trends, which results in the marked age difference in QRS-wave amplitude in limb leads. This merits the definition and use of age-specific ECG criteria for left ventricular hypertrophy.

关 键 词：心电描记术 QRS电轴 QRS波振幅 年龄分布 正常人群 

分 类 号：R540.4[医药卫生—心血管疾病]