健康特勤人员心电轴特点研究

Characteristics of ECG of healthy persons for special service

目的研究健康特勤人员心电轴特点,为其心血管功能专项医学鉴定提供参考依据。方法采用12导同步心电图仪采集2718名特勤人员心电图,测量心电轴相关参数并进行统计分析。结果健康特勤人员平均心电轴为+60.7°±27.4°,最大变动范围达-109°～+120°,其中95.0%(2581/2718)的心电轴位于-30°～+90°,4.4%(119/2718)的心电轴>+90°,0.7%(18/2718)的心电轴<-30°;心电轴偏移与体重指数呈一定的负相关性(r=-0.35),肥胖者心电轴趋于左偏,瘦长体型者则趋于右偏,但也有个别体型瘦长者心电轴偏移达-30°以上;心电轴<-30°者18例,14例(77.8%,14/18)符合SⅠSⅡSⅢ综合征诊断,其中体重指数<24kg/m2者占78.6%(11/14)。心电轴右偏者仅表现个别参数轻度异常,无右心室肥大及左后分支阻滞心电图特点,属正常变异。结论特勤人员心电轴绝大多数正常(-30°～+90°),少数心电轴偏移属正常变异,其中SⅠSⅡSⅢ综合征是引起心电轴显著左偏的重要原因,应注意鉴别。

Obiective To investigate the characteristics of the ECG of the persons for special service and provide the basis of the identification of cardiovascular function of them. Methods The 12-lead synchronization ECG instrument was used for collecting the ECGs of 2718 persons for special service. The axis related indexes were measured and the statistical analysis was performed. Results The average axis of the healthy persons for special service was ＋60.7°±27.4°. The maximum variation ranged from -109° to ＋120°, in which the axis fell in between -30°and ＋90°in 95% （2581/2718） persons, 〉＋90°in 4.4%（119/2718） persons and 〈- 30°in 0.7% （18/2718） persons. The axis deviation had the negative relativity with the body mass index （r =-0.35）. The axis tended to deviate to the left in the fat people, and to the right in the slim persons. However, the axis deviation was more than -30°in some slim persons. There were 18 persons with the axis -30°, and among them 14 could accord with the diagnosis of SⅠSⅡSⅢ syndrome whose body mass index 〈24 kg/m^2 accounted for 78.6% （11/14）. The people with the right deviation of the axis only had mild abnormality in some indexes without the ECG characteristics of the hypertrophy of the right ventricle and the left posterior fasci-cular block, which was the normal variation. Conclusion The axis of most majority of the persons for special service （-30°- ＋90°） is normal. The deviation of the axis is the normal variation in the minority. The SⅠSⅡSⅢ syndrome is the main reason causing the significant deviation of the axis, which should be differentiated.