心电散点图解析策略之恒变微分法  

Analytical strategies for ECG scatter plot:Differential method of constants and variables

作　　者：景永明[1] 申继红[1] 耿一鸣 聂连涛 JING Yongming;SHEN Jihong;GENG Yiming;NIE Liantao(Department of Electrocardiogram,1.the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450014;the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450015,China)

机构地区：[1]郑州大学第二附属医院心电图科,河南郑州450014 [2]郑州大学第五附属医院心电图科,河南郑州450015

出　　处：《实用心电学杂志》2023年第2期123-129,共7页Journal of Practical Electrocardiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220435)。

摘　　要：目的探讨RR间期的恒变性质对心电散点图位置及走向的影响,总结恒变微分法在快速分析动态心电图中的应用与分析技巧。方法结合室性早搏、室性早搏连发、房性早搏等经典病例的RR间期特征,分析其散点图特征点集的位置及走向与RR间期恒变性质的关系,总结恒变微分法的解析策略。结果时间散点图中RR间期为恒量时呈水平走向(如NV、VV层等),为变量时则呈上、下起伏(如NN、SN、VN层等)。Lorenz散点图中横坐标为恒量时,特征点集垂直分布(如NVN、VVN点集等),纵坐标为恒量时,特征点集水平分布(如NNV、VNV点集等),横、纵坐标均为恒量时特征点集局限性分布(如NVV、VVV点集等);横、纵坐标均为变量时,特征点集倾斜分布(如VNN、NNN点集等),且根据微分学原理,其主轴斜率取决于两变量的系数之比。结论RR间期的恒变性质决定了心电散点图的位置及走向。通过散点图技术快速识别的恒量与变量可以揭示心律失常的部分电生理机制,类似于天然的电生理检查。恒变微分法是解析心电散点图的有效方法,更是快速分析动态心电图的基本技能。Objective To explore the effect of the constant and variable nature of RR interval on the position and trend of ECG scatter plot,and to summarize the application and analytic techniques of differential method of constants and variables in rapid analysis of ambulatory electrocardiography(AECG).Methods Combined with the RR interval characteristics of classic cases such as premature ventricular contraction(PVC),consecutive PVC and atrial premature beats,we analyzed the relationship between the position and trend of the characteristic point set,and the constant and variable nature of RR interval.The analytical strategy of differential method of constants and variables were summarized.Results In the time scatter plot,when RR interval is a constant,the trend is horizontal(such as NV,VV layer,etc.);when RR interval is a variable,the scatter plot is manifested by fluctuating up and down(such as NN,SN,VN layer,etc.).In the Lorenz scatter plot,when the abscissa is a constant,the characteristic point set is vertically distributed(such as NVN,VVN point set,etc.);when the ordinate is a constant,the characteristic point set is horizontally distributed(such as NNV,VNV point set,etc.);when the abscissa and ordinate are both constants,the distribution of the characteristic point set is localized(such as NVV,VVV point set,etc.).When the abscissa and ordinate are both variables,the characteristic point set has a oblique distribution(such as VNN,NNN point set,etc.),and the slope of its principal axis depends on the ratio of the coefficients of the two variables according to the principal of the differential calculus.Conclusion The constant and variable nature of RR interval determines the position and trend of ECG scatter plot.The constant and variable rapidly identified by scatter plot technique can reveal parts of the electrophysiological mechanism of arrhythmia,which is similar to a natural electrophysiological examination.Differential method of constants and variables is an effective method for analyzing ECG scatter plot,and it

关 键 词：RR间期 恒量 变量 时间散点图 LORENZ散点图 室性早搏 房性早搏 恒变微分法 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]