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|本期目录/Table of Contents|

差电位图诊断心肌梗死的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第1期
页码:
10-12
栏目:
论著
出版日期:
2000-01-25

文章信息/Info

Title:
Diagnostic value of departure maps for myocardial infarction
作者:
张丙芳1; 臧益民2; 刘翠华3;  贾敏江4; 朱妙章2;  黄志兰1;  贾国良1;  王跃民2
第四军医大学:1 西京医院; 2 生理学教研室， 陕西 西安 710032; 3 武警陕西总队医院; 4北京军事科学院卫生处
Author(s):
ZHANG Bing-fang 1; ZANG Yi-min1; ZHU Miao-zhang2;  HUANG Zhi-lan 1; JIA Guo-liang1; WANG Yao-min2
1 Xijing Hospital, 2Department of Physiology, Fourth Military Medical University, Xi′an 710032, Shaanxi, China
关键词:
体表电位标测;  差电位图;  心电图;  冠状动脉疾病;  心肌梗死
Keywords:
body surface potential mapping; departure maps; electrocardiogram; coronary disease; myocardial infarction
分类号:
R540.41
DOI:
-
文献标识码:
A
摘要:
为了探讨体表差电位图对心肌梗死(MI)的诊断价值,应用BSPM-Ⅲ型体表电位标测微机系统和KT500全体表心电分析系统,对42例对照组和42例MI患者进行了差电位图的研究,并与常规心电图(ECG)对比分析。结果表明:前壁MI在心室除极10 ms时,左前胸上部出现差电位图偏离指数(DI)＜-2的区域,持续20～30 ms。下壁MI在心室除极20 ms时,前胸和后背下部均为DI＜-2的区,至QRS 40～50 ms负区范围缩小或消失。且DI异常负区与心室造影局部射血分数降低的节段相一致,其范围与射血分数降低的节段数有关。DI诊断MI的阳性率为100.0%,而ECG为81.0%,二者差异显著(P＜0.05)。提示:体表差电位图DI是检测MI的敏感指标,诊断价值显著高于ECG,且能够确定MI的部位和范围。
Abstract:
To explore the diagnostic value of body surface departure maps for myocardial infarction (MI). The departure maps were researched in 42 normals and 42 patients with MI using a BSPM-Ⅲ model computer system and a KT500 whole body surface electrocardiographic analysis system. The findings were also compared with electrocardiogram (ECG). The results showed that the less than 2 negative areas of departure index (DI) in patients with anterior MI were appeared in upper of left anterochest at 10 ms of ventrical depolarization and lasting about 20～30 ms; To the patients with inferior MI, the negative areas of DI were apppeared of under chest and back at 20 ms of ventrical depolarization, and these negative areas reduced or disappeared at 40～50 ms of QRS. The abnormal negative areas of DI were the same to the domains with local ejection fraction reduction in ventriculography,and we found the negative area′s size had much to do with the amount of those domains. The positive rates of DI and ECG for diagnosing MI was 100.0% and 81.0% respectivly. The difference between two methods was statistically sigificant (P＜0.05). The results suggested that DI was a sensitive index to diagnosing MI, its diagnostic value was more important than ECG and could also locate the area and the scope of MI.

参考文献/References

[1] Cooksey JD,Dunn M,Massie E. Clinical vectorcardiography and electrocardiography[M]. 2nd ed, Year Book. Chicago,1997.

[2] 张丙芳,臧益民. 体表电位标测[J]. 心功能杂志,1998;10(1):25,10(2):98.

[3] Mirvis DM. Current status of body surface electrocardiographic mapping[J]. Circulation, 1987,75(4):684.

[4] 张丙芳,臧益民,贾国良,等. 体表电位T峰值标测对冠心病的诊断价值[J]. 陕西医学杂志,1998,27(6):323.

[5] Ikeda K,Yamaki M,Honma K,et al. Use of body surface electrocardiographic mapping to localize the asynergic site in previous myocaridal infarction[J]. J Electrocardiol,1990,23(1):13.

[6] Hirai M,Ohta T,Kinoshita A,et al. Body surfce isopotertial maps in old anterior myocardial infarction undetectable by 12 lead electrocardiograms[J]. Am Heart J,1984,108:975.

备注/Memo

备注/Memo:
收稿日期：1999-09-20.基金项目：陕西省自然科学基金!资助项目 ( No.97SM56)
更新日期/Last Update: 2000-01-25