212例心电轴左偏的心电图和心向量图分析

Electrocardiogram of 212 Cases with Left Axis Deviation Are Compared with Their Vectrocardiogram

对２１２例心电轴左偏的心电图与心向量图进行对照分析，结果仅４６例符合单纯性左前分支传导阻滞（占２６．４２％），其电轴多分布在－４５°以上．而在６２例单纯性电轴左偏中，其电轴多在－４４°以下，两者差异非常显著（Ｐ＜０．０１），说明电轴左偏－４５°以上，诊断左前分支传导阻滞可靠性大．但对５０岁以上，特别有冠心病、高血压病患者，即使电轮在－３０°～－４４°，只要图型典型，也可考虑诊断左前分支传导阻滞，并建议有条件应参考向量图特征．对电轴左偏在－６０°以上者，更要结合临床资料，排除假性电轴左偏可能，并提出对假性电轴左偏的心电图诊断条件．

Electrocardiogram (ECG) of 212 cases with left axis deviation (LAD) are compared with their vectrocardiogram (VCG). The result showes that only 46 cases with pure left anterior fascicular block (LAFB) (26.42% ) are coincidence and the majority of these axes are above -45°. However in 62 cases with simple LAD,the majority of these axes are under -44°, the difference is significantly (P<0. 01). It showes that LAD above -45°,as diagnosis standard of LAFB, has good reliability. But in patients over 50 years old,especially associated with coronary heart disease and hypertension,even if the axis is between -30°and -44°,the typical graph is appeared the diagnosis of LAFB may be considered. If possible,the VCG may be refered to. If theaxis is above -60°, it must be combined with the clinic data,to get rid of false LAD. The diagnostic standard of ECG of false LAD is given.