健康成年人群碎裂QRS波群的检出与意义  

Fragmented QRS complexes in healthy adults:prevalence and implications

作　　者：张颖[1] 刘兴鹏[1] 闫倩[1] 黎旭[1] 于立群[2] 刘小慧[1] 董建增[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科二病房,北京100029 [2]首都医科大学附属北京安贞医院体检中心

出　　处：《临床心血管病杂志》2011年第4期299-302,共4页Journal of Clinical Cardiology

基　　金：教育部新世纪优秀人才资助计划(No:NCET-08-0626)

摘　　要：目的:研究碎裂QRS波群(fragmented QRS,fQRS)在健康人群中的检出率、分布规律及临床意义。方法:前瞻性入选连续1 000例无症状的健康体检者(年龄18～65岁),采集其静息状态下的常规心电图。fQRS的定义为至少2个连续导联的QRS波群存在≥2个R波或者R波的波顶或S波的波谷出现切迹。通过Logistic多因素分析确定与fQRS检出相关的指标。结果:总计86例(8.6%)检出fQRS,其中男性占69.8%(60/86),平均每例的fQRS导联数目为(2.3±0.5)个。90.7%(78/86)的fQRS分布于下壁导联,另9.3%(8/86)分布于胸前导联。Logistic多因素分析显示,QRS时限偏长及额面心电轴<30°是健康成人常规心电图检出fQRS的独立相关因素。胸前导联呈现fQRS的导联(8例)均包含QRS移行所在导联。结论:①fQRS在健康成年人群中并不罕见,特别是在下壁导联;②健康成年人fQRS的产生似与轻度室内传导延缓和(或)平均心电轴有关。Objective：We aimed to investigate the prevalence,distribution and clinical implications of fragmented QRS（fQRS） in healthy adults.Method：A total of 1000 consecutive asymptomatic subjects underwent voluntary health examination（age： 18-65 years）,were prospectively enrolled in this study.The routine 12-lead ECG at rest was obtained in all subjects.fQRS was defined as presence of ≥1 additional deflections or notching within the QRS complex,including top of R wave or nadir of S wave,in at least two continuous leads.The independent factors associated with fQRS detection were analyzed by Logistic regression.Result：fQRS was detected in 86（8.6%） subjects in whom 60（69.8%） were male.The mean number of leads displaying fQRS was 2.3±0.5.Inferior leads were the most common（90.7%,78/86） location displaying fQRS,followed by precordial leads which accounts for 9.3%（8/86）.Longer QRS duration and the frontal QRS axis less than 30°were identified as two independent factors of displaying fQRS in standard 12-lead ECG.In addition,fQRS in the precordial leads covered the lead of QRS transition in all 8 subjects.Conclusion：①fQRS was not rare in healthy adults,particularly in inferior leads.②fQRS in healthy adults seemed to be associated with slightly intraventricular conduction delay and left deviation of frontal QRS axis.

关 键 词：碎裂QRS波群 健康成人 

分 类 号：R541.7[医药卫生—心血管疾病]