心电图短P-R间期观测研究

Observation on Short Electrocardiograph P R Term

目的：探讨和鉴别心电图短Ｐ－Ｒ间期的产生原因，为临床诊断、治疗提供依据。方法：检测１１５例受检者的常规导联心电图（ＲＬＥＣＧ）、头胸导联心电图（ＨＣＥＣＧ）、食管导联心电图（ＥＬＥＣＧ），对其中５５例临床可疑心律失常和ＲＬＥＣＧ示短Ｐ－Ｒ间期者行食管心房调搏电生理检查。结果：①Ｐ波出现率和振幅均值比较ＥＬＥＣＧ＞ＨＣＥＣＧ＞ＲＬＥＣＧ（Ｐ＜０．０１），出现率分别为１００％、９５％、９１％。②ＨＣＥＣＧＰ－Ｒ段均值（Ｐ＜０．０１）及变异系数＜ＲＬＥＣＧ。③ＲＬＥＣＧ波幅低、图形多变是产生心电图短Ｐ－Ｒ间期的主要原因。结论：作为无创伤性检查方法，ＨＣＥＣＧ和ＥＬＥＣＧ可以对短Ｐ－Ｒ间期者进行初步筛选，而经食管心房调搏能检测ＥＣＧ短Ｐ－Ｒ间期的电生理特性，对鉴别诊断有肯定价值。

Objective:This study was carried out to investigate and discriminate the mechanism of short electrocardiograph(ECG)P R term,and also to provide evidence for clinical diagnoses and treatments.Methods:115 patients ECG of routine leads(RLECG)、head chest leads(HCECG) and esophageal lead (ELECG) were indpected.Among whom,55 patients showing suspicious arrhythmia on clinic and short P R term of routine leads electrophysiological examination was carried out using transesophageal artrial pacing.Results:①The occurrence rate of P waves was 100%、95%and 91%respectively,the mean of amplitude appeared:ELECG>HCECG>RLECG (P<0.01);②Both the mean of P R term (P<0.01) and coefficient of variability of HCECG were less than that in RLECG;③The main reason producing short P R term was low amplitude and varied graph of RLECG.Conclusion:As a nodamaged method,HCECG and ElECG could carry out preliminary selection on the patients of short P R term and inspect electrophysiological character on the patients of short P R term by the method of transesophageal atrial pacing,which has definite value of differential diagnosis.