心电图QRS波群振幅的昼夜节律变化及与心率的相关性

Circadian behavior of QRS wave amplitude and it's association with heart rate

目的观察体表心电图QRS波群振幅昼夜节律变化及其与心率的相关性。方法24h动态记录36例健康者Ⅱ导联、Ⅴ1导联、Ⅴ5导联每小时最快、最慢心率时的QRS波群振幅数字和。将1d中24h分成4个时段,比较不同时段测量指标的变化及其与心率的相关性。结果在最慢心率时,Ⅱ导联和Ⅴ1导联QRS波群振幅均呈日高夜低节律变化,Ⅴ5导联与之相反;Ⅴ1和Ⅴ5导联振幅和以及3个导联振幅总和在601～1200时段及0001～0600时段高,1801～2400时段最低;在最快心率时未发现有类似变化。结论QRS波群振幅存在昼夜节律变化并与心率相关,不同导联有不同的变化规律。

Objective: To observe the circadian behavior of QRS wave amplitude of the electrocardiogram and its association with heart rate in healthy subjects. Method:QRS wave amplitude was recorded at the times of the maximal and minimal heart rates every hour in lead Ⅱ,Ⅴ_1 and Ⅴ_5 respectively by 24 hour ambulatory electrocardiogram in 36 healthy subjects. Every 24 hour was separated into four periods of time,and paired-samples t test was performed to reveal the presence of circadian various in the aforementioned parameter and its association with heart rate. Result:In the time of the minimal heart rates, the QRS wave amplitude in lead Ⅱ and lead Ⅴ_1 represented a circadian various, which increased in the daytime and decreased in the night. Whereas reverse behavior showed in lead Ⅴ_5 .The sum of the QRS wave amplitudes in lead Ⅴ_1 and lead Ⅴ_5 as well as the sum in the three leads presented different diurnal pattern, which increased in 6:01~12:00 and 00:01~06:00 , while decreased in 18:01~~24:00 . No analogous circadian behavior was detected in the time of the maximal heart rates. Conclusion:QRS wave amplitude shows a significant circadian, and associates with heart rate in healthy subjects. Different leads demonstrate dissimilar behaviors.