正常人胸表心电位场电势分布与导联参比点的关系  

Relationship between reference point potential and potential distribution of normal electrocardial field on the thoracic surface of healthy individuals

作　　者：李本富[1] 周翔[1] 

机构地区：[1]南方医科大学基础医学院病理生理学教研室,广东广州510515

出　　处：《南方医科大学学报》2008年第9期1640-1641,1645,共3页Journal of Southern Medical University

基　　金：国家自然科学基金(30471647)

摘　　要：目的探讨导联参比点对正常人体表心电位场电势分布的影响。方法选择健康体检者以中心电站和右前额为不同参比点,同步记录Wilson导联(V1～V6)及其扩展导联(V7～V9、V3R～V8R)和对应头胸导联(HV1～HV9、HV3R～HV8R),环绕胸部一周的相同测试点的心电图。分别计数两种导联相同测试点心电图T波倒置和主波倒置的宽/深Q波的例数,作对应导联的χ2检验进行比较。结果120例中V3R～V8R导联均为倒置T波、V1导联出现20%(24/120)的倒置T波,V4R～V8R导联QRS波均为主波倒置的宽/深Q波;而头胸导联的HV1和HV3R～HV8R的T波均为正立、HV4R～HV8R导联记录到主波正立的rs、RS或qRs波。两导联系统记录的正常心电图其相异波形在例数上有统计学差异(P<0.05)。头胸导联记录的QRS、T波体表心电位场电势均呈现一致向外的分布,而Wilson导联则均呈大致左正右负的偶极分布。结论正常人体表心电位场的电势分布取决于导联参比点,头胸导联的右前额参比点可能优于Wilson导联的中心电站。Objective To explore the effect of reference point on the potential distribution of normal cardioeleclric field of healthy individuals. Methods Two different reference points including central terminal and right forehead were applied to record electrocardiogram simultaneously from 15 testing points （V1-V6, VT-V9, V3R-V8r of Wilson lead （RL） and the same testing points （HV1-HV9, HV3R-HV8R）of head-chest （HC） lead around the torso of healthy individuals. Chi-square test was performed to observe statistical difference between the HCECGs and RLECGs according to different shapes of QRS and T waves. Results Among 120 healthy individuals, deformed ECGs appeared in V1 and HV3R-HV8R leads, with 20% （24/120） inverted T wave in V1 lead, 100% （120/120） in V3R-V8R leads, wide or deep Q wave 100% （120/120） in V4R-V8R leads. However, in the corresponding HC-lead system, T waves were all positive, and QRS waves were upright as the pattern ofrs, RS or qRs. There was statistical difference in the form of ECG between V, V3R-V8R of Wilson lead and the corresponding HC-lead （P〈0.05）. The distribution of normal cardioeleclric field related to QRS-T wave was of all-round outward shape by HC-lead, and of roughly bipolar shape by Wilson lead for inverted QRS-T wave on the right thoracic surface. Conclusion The normal distribution of electrocardial field is determined by the potential of the reference point. The forehead of HC-lead seems to be better than the central terminal as the reference point of the lead system.

关 键 词：头胸导联 心电图 电势分布 参比点 

分 类 号：R540.4[医药卫生—心血管疾病]