青少年游泳运动员早复极心电图特征分析  

The characteristics and significance of early repolarization on electrocardiography in adolescent swimmers

作　　者：陆悠[1] 郑碧芳 熊芳 唐蓉蓉[1] 毛家亮[1] 何奔[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,200001 [2]上海市卢湾区体育科学研究所,200020 [3]上海市卢湾游泳学校,200020

出　　处：《临床心电学杂志》2012年第4期257-259,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨10￣14岁青少年游泳运动员心室早复极的心电图特征和意义。方法选取10￣14岁青少年游泳运动员139例,以心电图下壁(Ⅱ、Ⅲ、aVF)和侧壁(Ⅰ、aVL、V4、V5、V6)导联中至少连续两个导联的J点抬高作为早复极的指标,将运动员分为J点无抬高、J点抬高<0.1mV和J点抬高≥0.1mV三组。以运动员为试验组,同龄普通青少年为对照组,比较其J点抬高的发生概率和程度,以及心室率、QTc和RV5+SV1振幅的差异性。并分别比较三组运动员心室律、QTc和RV5+SV1的差异性。结果①与同龄青少年相比,青少年游泳运动员J点抬高以及抬高≥0.1mV的比例升高(p<0.01),但均未超过0.2mV;②与同龄青少年相比,青少年游泳运动员心率较慢,QTc较长(p<0.01);③与同龄青少年相比,青少年游泳运动员RV5+SV1均在正常范围内且差异无统计学意义;④三组运动员组间比较,随着J点的抬高,心率有轻微下降的趋势,QTc有轻微延长的趋势,但RV5+SV1差异无统计学意义。结论①在10￣14岁青少年游泳运动员中,J点抬高是一个较为普遍的现象,但一般不超过0.2mV。如果J点抬高≥0.2mV,则发生恶性室性心律失常的概率可能会增加,因此有必要给予密切监控和进一步检查;②随着J点的抬高,心室率轻微减慢和QTc轻微延长的趋势,可能意味着J点抬高的程度与心输出量的增加和迷走神经兴奋性升高有一定的关联;③本研究没有发现青少年游泳运动员的早复极与左室高电压有相关性。Objective To examine the characteristics and significance of Early repolarization（ER） on elec- trocardiography in adolescent swimmers. Methods We selected 139 adolescent swimmers （86 males, 53 females; age range, 10-14）. ER was defined as J point elevation≥0.1mV in at least two consecutive inferior （ Ⅱ, Ⅲ, aVF） or lateral leads （I, aVL, V4-V6）. Adolescent swimmers were divided into 3 groups according to absence of J point elevating, J point elevating〈0.1mV and J point elevating≥0.1mV. Additionally, we included measurements of heart rate and QTc. Furthermore, comparisons were made with age matched control common adolescents with normal ECG. Results ①J point elevating was present in 78.4% of swimmers and in 26.7% of common adoles- cents （p=O.001）. J point elevating1〉 0.1mV was present in 36% of swimmers and in 4.7% of common adolescents （p=0.001）. But none showed J point elevatin≥0.2mV. Adolescent swimmers had a significant lower heart rate （male 71.7±9.0 vs. 77.9±11.0 bpm,female 71.5±10.7 vs. 80.8±11.6 bpm,p=O.001） and longer QTc （male 0.41± 0.03 vs. 0.39~0.02s,female 0.41±0.02 vs. 0.40＋0.02s, p=0.001 ） compared to common adolescents; ②Among the three groups of adolescent swimmers, there were two slight trends towards slower heart rate （72.8±10.2bpm vs. 71.8±8.9bpm vs. 70.4±10.2bpm）, and longer QTc （0.407±0.02% vs. 0.408±0.027s vs. 0.415±0.021s） with J point ele- vating. Conclusion ①J point elevating （〈0.2mV） is found more frequently among adolescent swimmers than common adolescents. J point elevating≥ 0.2mV may increase the risk of ventricular fibrillation or sudden cardiac death. So close monitoring during swimming training and further medical examination are greatly necessary; ②With J point elevating, the slower heart rate and longer QTc of adolescent swimmers may result from increasedcardiac output and improved vagal excitability.

关 键 词：青少年游泳运动员 早复极 

分 类 号：G861.1[文化科学—体育训练]