心电图PR段改变对急性心包炎的临床诊断价值

Clinical Significance of PR Interval on Electrocardiogram for Diagnosis of Acute Pericarditis

目的探讨体表心电图PR段改变对急性心包炎的临床诊断价值。方法对60例急性心包炎病人不同时间记录的首次心电图进行分析，测量各导联PR段的方向和幅度。以60例心肌梗死和60例早期复极综合征为对照。结果60例急性心包炎病人中，44例（73.3％）在Ⅰ、Ⅱ、Ⅲ、aVF、V3～V6导联普遍出现PR段下移，aVR导联出现PR段抬高。普遍导联PR段改变的检出率在发病第1天。第2天记录的心电图中最高，达88．6％，随后记录的心电图中逐渐降低。在心肌梗死中有1．7％记录到普遍PR段下移，在早期复极综合征中普遍PR段下移的检出率也为1．7％。结论普遍导联PR段下移是急性心包炎早期心电图的特征性改变。

Objective To investigate clinical significance of PR interval on surface electrocardiogram for diagnosis of acute pericarditis. Methods The electrocardiograms of 60 patients （pts） with acute pericarditis were analyzed according to onset of the disease. The orientation and amplitude of PR interval in each lead were analyzed. Sixty pts with early repolarization syndrome were analyzed as control group . Results Of 6 0 pts with acute pericarditis , 4 4 （73.3 % ） had PR interval depression in leads Ⅰ,Ⅱ , Ⅲ, aVF and V3 - V6. PR interval were elevated in lead aVR. The incidence of PR interval changes was the highest during one to two days, then was gradually decreased. The incidence of generalized PR interval depression in early repolarization syndrome was 1.7%. Conclusion Generalized PR interval depression was the early characteristic changes of electrocardiogram in acute pericarditis.