改良的RR间期散点图及其逆向技术在经典病态窦房结综合征诊断中的临床应用  

Clinical application of improved RR interval scatterplot and its reversal technique in diagnosing typical sick sinus syndrome

作　　者：向黎明[1] 刘鸣[1] 

机构地区：[1]武汉亚洲心脏病医院心肺功能检测中心,湖北武汉430022

出　　处：《实用心电学杂志》2016年第6期393-397,403,共6页Journal of Practical Electrocardiology

基　　金：武汉市卫计委临床医学科研基金项目(WX15B01)

摘　　要：在临床工作中,我们用动态心电图分析软件中自带的L o m o z f点图制作系统分析经典病态窦房结综合征（ sick sinus syndrome,SSS） 患者的R R 间期散点图时,发现其无法显示〉2 s的长间期的散点图图形改变.本文将Lorenz散点图制作系统中的坐标上限由原来的2 s 设为4 s ,比较两种坐标上限下所作R R 间期散点图图形的异同,并采用逆向分析技术加以确认.结果发现改良后R R 间期散点图的吸引子多了 1 - 4 个,且能显示完整的散点图形状,而以2 s为坐标上限的散点图只能显示局部特征.因此,以2 s 为坐标上限制作R R 间期散点图来辅助诊断S S S是不合适的,以4 s 为坐标上限的“改良版” R R 间期散点图能更全面、更有效地反映S S S 的散点图特征.In clinical practice, we construct RR interval scatterplot of patients with typical sicksinus syndrome（SSS） with Lorenz scatterplot mapping system included in AECG analysis software.However, in this way, the graphic changes of long interval（ 〉 2 s ） can not be shown in the scatterplot.The upper limit of coordinates in Lorenz scatterplot mapping system is reseted from original 2 sto 4 s. This paper compares the similarities and differences of RR interval scatterplots in the two upperlimits of coordinates, and makes confirmation with reversal analysis technique. Our study revealedthat attractors were more than before by 1 to 4 in the improved RR interval scatterplot whichcan show complete scatterplot graphs. However, the scatterplot in a coordinate upper limit of 2 s canonly display local features. Therefore, it is not appropriate to make auxiliary diagnosis of SSS withthe RR interval scatterplot in a coordinate upper limit of 2 s. Its improved version taking 4 s as theupper limit of coordinates can reflect the characteristics of SSS scatterplot more completely and moreeffectively.

关 键 词：RR间期散点图 逆向技术 病态窦房结综合征 窦性停搏 

分 类 号：R540.41[医药卫生—心血管疾病]