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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。
Objective To compare the differences between limb lead electrocardiogram (ECG) in normal 12 leads and corresponding normal head electrocardiogram (ECG) in healthy subjects. Methods Healthy people were selected to record the electrocardiogram (ECG) and head-chest lead ECG (ECG) simultaneously. Two senior electrophysiologists analyzed and made no abnormal ECG diagnosis. The two lead leads (CL2, CL4, CL6 and HV7, HV8, HV9 and HR3, HO, respectively) corresponding to the lead in the head and chest were respectively obtained with 6 limb leads (I, II, III and aVR, aVL, aVF) , HL3 and AR3, HR7, AL3), one by one paired ECG comparison. Observed ECG P, QRS, T wave morphology, count the lead of the same waveform of the pseudo-change were compared for the corresponding lead chi-square test were compared. Results In 120 healthy people’s normal electrocardiogram, the incidence of biphasic or inverted P wave in lead III was 31.6% in conventional limb leads, and 29.1% in wide or deep Q wave. Low or inverted T wave (26.7%). However, the incidences of false changes in CL6 or HV9 lead corresponding to head-chest leads were all zero (0.0%). The incidence of P wave and T-wave inversion in aVR lead was 100% While the incidence of inverted P and T wave of head and neck lead AR3 were both 18.3% and no false change of HR3 lead; the incidence of T wave inversion of aVL lead was 23.3%, while the lead of HO and HR7 was not false change. There was a statistically significant difference in the incidence of P-QRS-T wave in the normal ECG between the two lead systems (all P <0.01). Conclusion The incidence of false change of waveform in normal ECG and head-chest lead of healthy people is significantly lower than that of normal limb leads.