健康人睡眠期间卧位对心电图波形的影响  

Influence of Lying Position on ECG Waveform During Sleep in Healthy People

作　　者：潘弘泽 许志[1] 严洪[1] 梁仲刚[1] 高玥 陈章煌[1] 宋晋忠[1] Pan Hongze;Xu Zhi;Yan Hong;Liang Zhonggang;Gao Yue;Chen Zhanghuang;Song Jinzhong(China Astronaut Research and Training Center,Beijing 100094,China)

机构地区：[1]中国航天员科研训练中心

出　　处：《航天医学与医学工程》2018年第6期623-629,共7页Space Medicine & Medical Engineering

基　　金：总装重点试验技术项目(2014SY54A1102)

摘　　要：目的探讨健康人睡眠期间左侧卧、仰卧和右侧卧对心电图波形的影响。方法通过对ISRUC数据库中健康受试者整夜睡眠心电数据去噪,计算30个波形特征在不同卧位下的均值与显著性。其中S/R和∠QSR为本文提出的新指标。结果QT间期和RR间期在左侧卧时显著大于仰卧(P<O.01),P波与T波高度、QRS波与T波面积、QR电势差、∠QSR在左侧卧时显著小于仰卧(P<0.01),其中大部分指标在左侧卧时显著小于右侧卧(P<0.05);S/R在左侧卧时显著大于仰卧(P<0.01)和右侧卧(P<0.05)。T波高度和面积在仰卧时显著大于右侧卧(P<0.01)。结论左侧卧时心脏受重力作用的转动与摆动引起了额面心电向量图的变化,进而引起心电图变化;右侧卧时心脏受到纵膈支撑自由度较差,心电图波形几乎不变。Objective To explore the influence of lying positions,including left lying,supine and right lying,on the shape of ECG waveform during sleep. Methods By means of de-noising the overnight sleep ECG data from ISRUC website dataset,the means and significant difference levels of 30 ECG waveform features within different lying positions were calculated including 2 newly proposed features. Results QT interval and RR interval were significantly lower in supine than that in left lying( P < 0. 01). When lying on the left side,the height of P wave and T wave,the area under the QRS complex and T wave,the QR potential difference and∠QSR in triangle QRS were significantly lower than those in supine( P < 0. 01). And most of the features were significantly smaller than those in right lying. However,the amplitude ratio of S wave to the corresponding R wave was significantly greater in left lying than those in supine( P < 0. 01) and those in right lying( P <0. 05). The height of T wave and area under T wave were significantly higher in supine than those in right lying( P < 0. 01). Conclusion When subjects are lying on the left during sleep,due to the effect of gravity on heart,the position of heart changes,for example,turns and rotates,causing changes in the VCG of frontal plane and horizontal plane,which leads to a changes in ECG. When lying on the right side,the heart is upheld by the mediastinum,so that the degree of freedom is poor,and the ECG waveform is almost unchanged.

关 键 词：心电图 波形 睡眠 卧位 

分 类 号：R318.11[医药卫生—生物医学工程] R319[医药卫生—基础医学]