应用电轴垂线法判定心电轴200份评价  

Evaluation of 200 applications of the electrical axis vertical method for determining the electrocardiogram axis

作　　者：高启军 别芳芳 陈亚锋 GAO Qijun;BIE Fangfang;CHEN Yafeng(Department of Cardiology,Jingmen Central Hospital,Jingmen Central Hospital Affiliated to Jingchu University of Technology,Jingmen,Hubei 448000,China)

机构地区：[1]荆门市中心医院、荆楚理工学院附属荆门市中心医院心内科,湖北荆门448000

出　　处：《安徽医药》2024年第9期1833-1836,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的寻找一种更简单、快速地确定心电轴的方法。方法电轴的垂线将6个肢体导联分为两组。电轴方向180°范围内的所有导联均为正向,而电轴方向相反的180°范围内的所有导联均为负向,电轴垂线相邻的两个导联QRS波群主波方向相反,以此帮助确定电轴垂线。六个肢体导联在−30°~120°分布如下:aVL(−30°),Ⅰ(0°),−avR(30°),Ⅱ(60°),aVF(90°)和Ⅲ(120°)。先检查外侧导联(aVL或Ⅲ)是否为负向或正负相等,如果超过一个导联是负的,按顺序逐一查看,直到发现一个正向或上下相等的导联。2019年7月荆门中心医院的200份心电图纳入分析,从电轴垂线法、电脑法和查表法得到心电轴,用Pearson法分析相关系数和Bland-Altman分析差异性。结果3种方法判定心电轴的均数和标准差相似,电轴垂线法与查表法的相关系数为0.976。两种方法之间的平均偏差及其95%CI为0.88(−12.37,14.14)。结论电轴垂线法简单,方便,能较准确地确定QRS电轴。Objective To identify a simpler and quicker method for determining the electrical cardiac axis.Methods The vertical lines of the electrical axis divided the six limb leads into two groups.All leads within 180°of the direction of the electrical axis are posi-tive,while all leads within 180°of the opposite direction of the electrical axis are negative.The two leads adjacent to the vertical line of the electrical axis with the main wave of the QRS wave group in opposite directions can to determine the vertical line of the electrical axis.The six limb leads were distributed from-30°to 120°as follows:aVL(-30°),I(0°),-avR(30°),Ⅱ(60°),aVF(90°)andⅢ(120°).The lateral leads(aVL orⅢ)were checked first for negative or equal positive and negative,and if more than one lead was nega-tive,each was viewed in order until a positive or equal up and down lead was found.A total of 200 electrocardiograms from Jingmen Central Hospital in July 2019 were included in the analysis.Obtained the ECG axis from the electrical axis vertical lines method,the computer method,and the checklist method and analyzed the correlation coefficients and Bland‒Altman analysis of variance by the Pearson method.Results The means and standard deviations of the three methods for determining the cardiac electrical axis were sim-ilar,and the correlation coefficient between the electrical axis vertical line method and the checklist method was 0.976.The mean devi-ation between the two methods and its 95%CI was 0.88(-12.37,14.14).Conclusion The electrical axis plumb line method is simple and convenient and can be used to determine the QRS electrical axis more accurately.

关 键 词：心电描记术 平均心电轴 电轴垂线 QRS波群 

分 类 号：R540.41[医药卫生—心血管疾病]