头胸导联心电图在窄QRS波心动过速鉴别诊断中的作用  

The head-chest leads electrocardiogram in different diagnosis of narrow QRS complex tachycardias

作　　者：唐恺[1] 陈柯萍[2] 马坚[2] 周可[1] 于学靖[1] 张澍[1] 徐亚伟[1] 

机构地区：[1]同济大学附属第十人民医院心内科,200072 [2]中国医学科学院阜外心血管病医院,100037

出　　处：《临床心电学杂志》2007年第4期280-282,共3页Journal of Clinical Electrocardiology

摘　　要：目的观察在窄QRS波心动过速鉴别诊断时,头胸导联心电图是否优于常规12导联心电图。方法当患者发生窄QRS波心动过速时,同时记录常规心电图及头胸导联心电图各1份,由两位资深的电生理医生进行分析,作出心动过速机制的诊断。此后由观察者将两位医生分析两种体表心电图的结果与心内电生理检查的结果对照,计算出两种体表心电图诊断心动过速机制的准确率,并作卡方检验进行比较。结果41例患者入选本试验。第一位医生分析常规心电图的诊断准确率是80.5%(33/41),头胸导联心电图的准确率是90.2%(37/41);第二位医生分析常规心电图的诊断准确率是75.6%(31/41),头胸导联心电图的准确率是87.8%(36/41)。两位医生分析常规心电图的总体准确率是78.0%,头胸导联心电图的总体准确率是89.0%。两位医生在分析两种体表心电图的诊断准确率方面均无统计学差异(均为p>0.05)。结论在对窄QRS波心动过速鉴别诊断方面,头胸导联心电图似有比常规心电图更准确的趋势,但未显示出统计学差异。Objective To observe whether the head-chest leads electrocardiogram （HCECG） is better than the routine 12-leads electrocardiogram （RLECG） in different diagnosis of narrow QRS complex tachycardias. Methods HCECGs and RLECGs were recorded simultaneously when the narrow QRS complex tachycardias appeared. And each HCECG and RLECG was analyzed by 2 senior physicians of clinical electrophysiology. Then the results of the HCECGs and RLECGs were compared to the ones of intracardiac electrophysiology to get the information of the diagnostic accuracy of the HCECGs and RLECGs. And the chi-square test was performed to observe if there was statistical difference between the HCECGs and RLECGs in differentiation of narrow QRS complex tachycardias. Results The accuracy of the RLECGs was 80.5% （33/41）and 75.6% （31/41）in the 2 physicians, respectively. And the accuracy of the HCECGs was 90.2%（37/41）and 87.8%（36/41）in the 2 physicians, respectively. However, there was no statistical difference between the results of the HCECGs and the resuits of the RLECGs in the both physicians （,o〉0.05）. Conclusion The HCECG may be better than the RLECG in differentiation of narrow QRS complex tachycardia. But there was no statistical difference.

关 键 词：头胸导联心电图 常规12导联心电图 窄QRS波心动过速 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]