PR段偏移的特点及临床意义  

Features and clinical value of PR segment deviation in ECGC

作　　者：陈青萍[1] 黄学成[1] 邓梓谦[1] 张凤玲[1] 黄宁[1] 陈颖[1] 

机构地区：[1]广西医科大学第三附属医院,南宁530031

出　　处：《实用心电学杂志》2010年第2期95-96,共2页Journal of Practical Electrocardiology

摘　　要：目的探讨PR段偏移的特点及临床意义。方法收集不同时期首次心电图记录有PR段偏移者68例,测量各导联PR段及ST段的偏移情况,观察其各项临床资料特点。结果①PR段改变的方向与同导联ST段改变的方向相反,下移的幅度在0.05-0.15mV,抬高的幅度在0.05-0.10 mV;②68例PR段偏移者中急性心包炎59例（其中肿瘤性13例、结核性10例、尿毒症性8例、心脏手术性7例、化脓性7例、病毒性5例、自身免疫性5例、外伤性4例）,在Ⅰ、Ⅱ、Ⅲ、aVL、aVF、V3-V6导联出现普遍PR段下移而ST段抬高,aVR导联则表现为PR段抬高而ST段下移;③急性心肌梗死或合并有心房梗死9例,在面向梗死区的导联PR段下移而ST段抬高,对应导联PR段抬高而ST段下移。结论心电图PR段偏移强烈提示为急性心包炎或心房梗死。Objective To investigate the features and clinical value of PR segment deviation in ECG.Methods Measuring magnitude of PR segment and ST segment deviation in all lead of ECG recorded first in 68 cases with PR segment deviation at different times,and observing characteristics of their clinical data.Results ① The directions of PR segment deviation with depression in the range of 0.05 - 0.15mV were opposite to the direction of ST segment deviation with elevation in the range of 0.05 - 0.10 mV;② In these 68 cases,there were 59 cases with acute pericarditis,including 13 cases with neoplastic pericarditis,10 cases with tuberculous pericarditis,8 cases with uremic pericarditis,7 cases accepted cardiac surgical,7 cases with suppurative pericarditis,5 cases with viral pericarditis,4 cases with autoimmune pericarditis and 4 cases with traumatic pericarditis,and in lead Ⅰ,Ⅱ,Ⅲ,aVL,aVF,V3 ~ V6 the PR segment depressed with ST segment elevation,but in lead aVR expressed as PR-segment elevation with ST segment depression;③ There were 9 cases with acute myocardial infarction combined with atrial infarction,in the leads which faced infarct region PR segment depressed with ST segment elevation,and in reciprocal leads the PR segment elevated and ST segment depression.Conclusion In ECG PR segment deviation strongly suggests acute pericarditis or atrial infarction.

关 键 词：PR段 急性心包炎 心电图 

分 类 号：R540.41[医药卫生—心血管疾病] R542.11[医药卫生—内科学]