常规心电图与动态心电图不同导联连接方式对QRS波形的影响  

Influences of Different Connection Modes during ECG and AECGons QRS Waveforms

作　　者：陈华[1] 李全忠[1] 陈建中[1] 

机构地区：[1]桂林医学院附属医院心内科,广西桂林市541001

出　　处：《中国全科医学》2010年第27期3090-3092,共3页Chinese General Practice

基　　金：广西医药卫生自筹经费计划课题(Z2010315)

摘　　要：目的比较常规心电图(ECG)、动态心电图(AECG)采用Einthoven-Wilson12导联系统(A系统)和Mason-Likar12导联系统(B系统)连接方式时的各导联波形差异。方法 40例患者接受ECG、AECG检查,并分别采用A系统和B系统描记,每例4种描记10min内完成。结果 ECG两种导联系统的QⅡ、aVR、aVF、V4～6,RⅠ、Ⅱ、Ⅲ、aVR、aVL、aVF、V1～3,SⅠ、Ⅱ、aVL、V2～6振幅和电轴间差异有统计学意义(P<0.05):QⅡ、aVR、aVF、V4～6,RⅡ、Ⅲ、aVR、aVF,SⅠ、Ⅱ、aVL、V4振幅A系统较B系统小,RⅠ、aVL、V1～3,SV2～3、5～6振幅A系统较B系统大,电轴A系统较B系统左移;AECG两种导联系统QⅡ、aVR、aVL、V5～6,RⅠ、Ⅱ、Ⅲ、aVL、aVF、V1～3,SⅠ、Ⅱ、aVR、aVL、aVF、V1～6间差异有统计学意义(P<0.05):QⅡ、aVR、aVL、V5～6,RⅡ、Ⅲ、aVF,SⅠ、Ⅱ、aVR、aVL、aVF振幅A系统较B系统小,QV3,RⅠ、aVL、V1～3,SV1～6振幅A系统较B系统大;电轴A系统较B系统左移。结论 A系统与B系统记录的QRS波并不等同,不能以ECG标准诊断AECG;不同导联系统记录的QRS波形不能进行对比。Objective To compare the influences of different connection modes during ECG and AECG on QRS waveforms.Methods Totally 40 patients who had undergone ECG and AECG were enrolled in this study.All of them were examined in Einthoven-Wilson 12-lead system （system A） and Mason-Likar 12-lead system（system B） at an interval less than ten minutes.The QRS waveforms were compared.Results Wveforms between the two connection modes in QⅡ,aVR,aVF,V4-6,R,Ⅱ,Ⅲ,aVR,aVL,aVF,V1-3,SⅠ,Ⅱ,aVL,V2-6 and electrical axis were significantly different between these two groups （P0.05） during ECG.The amplitudes of QⅡ,aVR,aVF,V 4-6,RⅡ,Ⅲ,aVR,aVF,SⅠ,Ⅱ,aVL,and V4 in system A were smaller than those of system B.The amplitudes of RⅠ,aVL,V 1-3,SV 2-3,and 5-6were bigger than those of RⅠ,aVL,V1-3,SV 2-3,and 5-6.The axis of system A shifted left.There were also significant differences in QⅡ,aVR,aVL,V 5-6,RⅠ,Ⅱ,Ⅲ,aVL,aVF,V 1-3,SⅠ,Ⅱ,aVR,aVL,aVF,V 1-6,and electrical axis in AECGs （P0.05）.The amplitudes of QⅡ,aVR,aVL,V 5-6,RⅡ,Ⅲ,aVF,SⅠ,Ⅱ,aVR,aVL,and aVF in system A are smaller than those in system B.The amplitudes of QV3,RⅠ,aVL,V 1-3,SV 1-6 were bigger than those of RⅠ,aVL,V 1-3,SV 2-3,5-6.Compared to System B,the axis of system A shifted leftwards.Conclusion The QRS waveforms is not identical between System A and system B.The diagnostic criteria of ECG can not be applied to those of AECG.The QRS waveforms in different lead systems are not comparable.

关 键 词：动态心电图 常规心电图 Einthoven-Wilson 12导联系统 Mason-Likar 12导联系统 电轴 

分 类 号：R540.54[医药卫生—心血管疾病]