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Title:: Comparison of normal ECGs between limb lead and corresponding headchest lead in healthy subjects

作者:: 李本富; 周翔; 南方医科大学基础医学院病理生理学教研室，广东广州 510515

Author(s):: LI Benfu; ZHOU Xiang; Department of Pathophysiology, Basic Medicine College, Nanfang Medical University, Guangzhou 510515, Guangdong, China

关键词:: 头胸导联; 肢体导联; 心电图; 假性改变

Keywords:: headchest lead; limb lead; electrocardiogram; false change

分类号:: R540.41

DOI:: -

文献标识码:: A

摘要:: 目的比较健康人常规12导联中的肢体导联心电图与相对应头胸导联正常心电图之间的差异。方法选择健康体检者同时记录常规心电图及头胸导联心电图，由两位资深的电生理医生分析，作出心电图无异常的诊断。而后以6个肢体导联(I、II、III和aVR、aVL、aVF)分别与头胸导联中对应的各两组导联（CL2、CL4、CL6和HV7、HV8、HV9及HR3、HO、HL3和AR3、HR7、AL3），进行逐一配对的心电图比较。观察心电图P、QRS、T波的形态，计数各导联同一波形之假性改变者，作对应导联的卡方检验进行比较。结果在120例健康人正常心电图中，常规肢体导联中的III导联双相或倒置P波的出现率是31.6%、宽或深Q波的出现率是29.1%、低平或倒置T波的出现率是26.7%，而对应头胸导联的CL6或HV9导联上述假性改变的出现率均为零（0.0%）；aVR导联P波和T波倒置的出现率是100%，而对应头胸导联AR3倒置P、T波的出现率均为18.3％，HR3导联无假性改变；aVL导联T波倒置的出现率是23.3％，而HO和HR7导联无假性改变。正常心电图PQRST波假性改变在两导联系统的出现率有统计学上的差异（均为P<0.01）。结论健康人的正常心电图，头胸导联波形假性改变出现率比常规肢体导联显著降低。

Abstract:: AIM To observe whether the corresponding headchest (HC) lead electrocardiogram (HCECG) is more exact and accordant than the limb lead of routine 12lead electrocardiogram (RLECG) in the healthy subjects. METHODS HCECGs and RLECGs were recorded simultaneously in the healthy subjects and the normal diagnosis of each HCECG and RLECG was confirmed by the analyses of 2 senior physicians of clinical electrophysiology. The comparison was made between RLECGs and HCECGs, including 2 groups (I, II, III to CL2, CL4, CL6 and HV7, HV8, HV9), (aVR, aVL, aVF to HR3, HO, HL3 and AR3, HR7, AL3 ) respectively. ECGs were classified into the normal and false change according to the shape of P, QRS and T waves. The chisquare test was performed for statistical difference between the HCECGs and RLECGs in healthy subjects. RESULTS Among the 120 cases of healthy subjects, deformed ECGs appeared in III, aVR and aVL leads, for biphasic or inverted P wave 31.6% in III, 100% in aVR, wide or deep Q wave 29.1% in III, flat or inverted T wave 26.7% in III, 100% in aVR, 23.3% in aVL. However, in corresponding HClead inverted P or T wave appeared only in AR3 for 18.3％. Statistical difference was found between the results of the HCECGs and those of the RLECGs (P<0.01). CONCLUSION The false changes of HCECG may be significantly lower than those of RLECG in healthy subjects.

参考文献/References

［1］尹炳生，张缗. 常规临床心电图学与头胸导联临床心电图学［J］. 中国循环杂志， 1991， 6(1):75-77.

［2］崔长琮. 心电图导联系统［M］// 郭继鸿. 心电图学. 北京：人民卫生出版社， 2002：73-119.

［3］ Bacharova L, Selvester RH, Engblom H, et al. Where is the central terminal located? In search of understanding the use of the Wilson central terminal for production of 9 of the standard 12 electrocardiogram leads［J］. J Electrocardiol, 2005, 38(2):119-127.

［4］周翔. 心电位场的电势分布与导联参比点的关系［J］. 第一军医大学学报， 1999， 19（6）：614-617.

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正常人肢体导联心电图与对应头胸导联心电图的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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