健康飞行人员早复极心电图分型研究  

Research on the classification of early repolarization ECG in healthy flying personnel

作　　者：曹国辉[1] 李水睛[1] 戴伟川[1] 

机构地区：[1]广州军区桂林疗养院,541003

出　　处：《中华航空航天医学杂志》2016年第4期263-267,共5页Chinese Journal of Aerospace Medicine

摘　　要：目的研究健康军事飞行人员早复极的分型，为其医学鉴定提供参考依据。方法回顾性分析5254例健康飞行人员静息12导联同步心电图及医学鉴定资料，并按Heng和Tikkanen方法进行分型。结果①本组飞行人员早复极发生率为26．95％（1416／5254），其发生率随年龄增长而降低（X^2=21．59，P〈O．01），并且心率越慢早复极检出率亦越高（X^2=76．33，P％0．01）。②早复极波以下壁导联最为常见，占46．26％（655／1416），其次是下壁导联加左胸导联，占22．81％（323／1416），其他导联组合较少见。③Heng分型：以4型最为常见（43．36％），其次是2型（24．01％）和混合型（15．96％），1型（5．09％）、3型（2．40％）及5型（9．18％）少见。④Tikkanen分型：ST段绝大多数呈上斜型抬高（98．73％），仅个别呈水平型抬高（1．27％）；其中10例行活动平板运动试验均为阴性。结论健康飞行人员早复极常见，多呈低振幅窄时限的顿挫波，属于正常心电图变异。Heng和Tikkanen分型有助于早复极的分型与诊断规范化，两者结合可能有助于筛选早复极的高危患者。Objective To study the classification of early repolarization ECG in healthy flying personnel, and to provide reference for medical identification. Methods The 12-lead synchronous ECG and medical identification data of 5 254 healthy flying personnel were reviewed and classified by Heng and Tikkanen methods. Results ① The incidence of early repolarization was 26. 95% （1 416/5 254） and reduced with the age growing （X^2 =21.59, P〈0.01）. The slower heart rate the higher early repolarization incidence （X^2 =76. 33, P〈0. 01）. ② The early repolarization wave was most frequently found by inferior wall lead cheek that took 46.26 % （655/1 416）, then the inferior wall lead with right precordial lead that took 22. 81% （323/1 416）. Other leads or lead combinations contributed less. ③Heng classification; type 4 was the commonest （43.36%）, then followed by type 2（24.01%）, and hybrid type （15.96%）. Type 1（5.09%）, type 3（2.40%） and type 5（9.18%） took smaller portion. ④Tikkanen classification： 98.73 % S-T segment elevations were superior oblique type while only 1. 27% represented horizontal type. Negative results were got in 10 cases of treadmill exercise test. Conclusions Early repolarization ECG is very common in healthy flying personnel.Itrs usually characterized by low amplitude and short duration J wave and belongs to the variation of normal ECG. Heng and Tikkanen methods would be helpful to normatively classify the early repolarization ECG and to screen the high-risk population.

关 键 词：心电描记术 早复极 Heng分型 Tikkanen分型 飞行人员 

分 类 号：R856.5[医药卫生—航空、航天与航海医学]