常规心电图与动态心电图不同导联连接方式对ST-T的影响  

Impact of Different Connection Modes for ECG and AECG on ST-T Waveform

作　　者：陈华[1] 李全忠[1] 秦阳亮[2] 唐卫民[2] 池慧[1] 

机构地区：[1]桂林医学院附属医院心内科,广西桂林市541001 [2]桂林电子科技大学

出　　处：《中国全科医学》2011年第23期2673-2675,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）不同连接方式时ST-T的差异性。方法对100例接受ECG、AECG检查者,分别采用A系统和B系统描记,每例患者的4种描记方式在10 min内完成。结果 ECG检查中,与A系统比较,B系统Ⅲ、V1、V5导联的J点及Ⅲ、V1、V3、V4导联的ST段下移明显,aVR、V1~5导联的T波振幅降低,Ⅰ、Ⅱ导联的T波振幅增高,差异有统计学意义（P〈0.05）。AECG检查中,与A系统比较,B系统Ⅱ、Ⅲ、aVR、V2、V6导联的J点下移,Ⅱ、Ⅲ、V1、V2、V6导联的ST段下移,aVR、V2、V3、V5、V6导联的T波振幅降低,aVR、aVL导联的ST段抬高,差异有统计学意义（P〈0.05）。结论 A系统与B系统ST-T的改变并不相同,不能以ECG的标准诊断AECG,AECG诊断心肌缺血时应慎重,以免误诊。Objective To compare the differences in ST-T waveform between Einthoven-Wilson 12-lead system（system A） and Mason-Likar 12-lead system（system B） during ECG and AECG.Methods Totally 100 patients underwent ECG and AECG under both systems（A and B）,with all examinations finished within ten minutes.Results Measurements of ST-T between the two connection modes in the ECG examination were significantly different（P〈0.05）;compared with system A,system B generated lower ⅢJ,V1J,V5J,lower ⅢST,V1ST,V3ST,V4ST,smaller amplitude of aVRT,V1T,V2T,V3T,V4T,V5T,and bigger amplitude of ⅠT,ⅡT.Also,system B generated lower ⅡJ,ⅢJ,aVRJ,V2J,V6J,lower ⅡST,ⅢST,V1ST,V2ST,V6ST,smaller amplitude of aVRT,V2T,V3T,V5T,V6T,higher aVRST,aVLST,with significant differences（P〈0.05）.Conclusion ST-T waveform are not identical between system A and system B.The diagnostic criteria of ECG can not be applied to AECG.AECG diagnosis of myocarelial ischemia should be cautious to avoid misdiagnosis.

关 键 词：心电描记术 Einthoven-Wilson12导联系统 Mason-Likar12导联系统 心肌缺血 

分 类 号：R540.41[医药卫生—心血管疾病]