正常人右胸头胸导联心电图特征

Character of Right Precordial Head Chest Lead Electrocardiogram in NormalSubjects

目的评价一种新的右胸导联心电图：头胸（ＨＣ）导联心电图的应用价值。方法对６４例正常人描记同时间、同部位的Ｗｉｌｓｏｎ导联（Ｖ３Ｒ～Ｖ７Ｒ）和ＨＣ导联（Ｈｖ３Ｒ～Ｈｖ７Ｒ）图形。结果两种导联方法心电图均无ＳＴ段抬高；ＨＶ５Ｒ～ＨＶ７Ｒ直立Ｐ波多于Ｖ５Ｒ～ｖ７Ｒ（Ｐ均（０．０５）；病理Ｑ波（Ｑ≥１／４Ｒ，ｔ＞０．０４秒）或Ｑｒ型波在Ｖ４Ｒ为６％，Ｖ５Ｒ为５６％，Ｖ６Ｒ为６２％，Ｖ７Ｒ为６５％，Ｔ波直立者仅１２％，然而ＨＣ导联均为Ｒ型或石型，Ｔ波直立者达８８％。Ｑ波出现率在Ｖ５Ｒ和ＨＶ５Ｒ、Ｖ６Ｒ和ＨＶ６Ｒ、Ｖ７Ｒ和ＨＶ７Ｒ间呈显著差异（Ｐ均＜０．００１），直立Ｔ波出现率在Ｖ３Ｒ～Ｖ７Ｒ和ＨＶ３Ｒ～ＨＶ７Ｒ间亦有明显差异（Ｐ波＜０．０１）。根据图形特征，ＨＣ导联右胸图形可分为３型：（１）ＨＶ３Ｒ～ＨＶ７Ｒ呈Ｒ型伴Ｔ波直立者占５５％；（２）ＨＶ３Ｒ～ＨＶ５Ｒ为ｒＳ型，ＨＶ６Ｒ和ＨＶ７ＲＲ型伴Ｔ彼直立者占３３％；（３）ＨＶ３Ｒ～ＨＶ７Ｒ均呈ｒＳ型伴Ｔ波平坦者占１２％。结论由于ＨＣ导联右胸心电图在健康人群中表现为正常的Ｐ－ＱＲＳ－Ｔ波群，故有益于右室疾病的诊断。

Objective To evaluate the applicationvalue of a new right precordial ECG-Head Chest(HC)lead ECG. Method 64 normal subjects werestudied by Wilson leads(V3R～V7R)comparingwith HC leads(HV3R～HV7R)in the same time andlocation,Results None had ST segment elevation inwilson or HC lead ECG. Positive P wave in HV5R～HV7R was more than that in V5R～V7R(all P<0.05).Pathological Q wave (Q≥1/4R,t>0.04s)orQr wave was found 6%in V4R,56%in V5R,62%in V6R,65%in V7R and positive T wave in 12%,however R or rS shape showed in all HC leads andpositive T wave in 88%.There was significant differ-ence in Q wave in V5R and HV5R,V6R and HV6R,V7R and HV7R(all P<0.001),in positive T wave inV3R～V7R and HV3R～HV7R(all P<0.01).Theconfiguration R or rS shapeh HC leads was divded into 3 patterns:(1) R shape and tall T wave inHV3R-HV7R in55%;(2)rS Shape in HV3R～HV5R Changed into R shape in HV6R,HV7R in33% with positive T wave;(3)rS shape and flat Twave in HV3R ～HV7R in 12%。Conclusions SninceHC lead ECG showed normal P-QRS-T complex inright thorax of health people,it was beneficial to de-tecte the disease of right ventricle.