β受体功能亢进症儿童立位与卧位同步12导联心电图T波及ST段变化的意义

Significance of Changes of T Wave and ST Segment Variation in 12-Lead Simultaneous Body Surface Electrocardiogram Under Supine and Erect Position in Children with beta Adrenoceptor Hyperfunction Syndrome

目的探讨β受体功能亢进症儿童立位与卧位同步12导联心电图（12 ECG）T波及ST段变化的意义。方法β受体功能亢进症儿童（研究组）53例。男13例,女40例;年龄3.5~18.0（8.77±2.99）岁。广东中山SR-1000A心电综合自动分析仪描记卧位及立位12 ECG。匹配健康儿童40例为健康对照组。计算立位与卧位心率差及T波、ST段振幅及形态变化。采用SPSS 11.0软件进行统计学分析。结果1.研究组发病年龄高峰为7~11岁。男女比例约为1：3。2.研究组立位较卧位心率增加幅度显著高于健康对照组[（17.96±10.16）次/minvs（9.67±6.97）次/min P〈0.01]。3.T波形态：研究组立位与卧位比较,T波振幅降低主要在Ⅱ、V3、V4、V5、V6导联,T波倒置主要在Ⅲ、aVF导联,T波倒置且振幅增加主要在Ⅲ、V1、V2导联,卧位时T波倒置变为立位时T波直立出现在V1、V2导联。4.T波振幅：研究组立位较卧位T波振幅下降幅度在V1导联大于健康对照组（P〈0.05）,在V2导联显著大于健康对照组（P〈0.01）。5.ST段振幅：立位较卧位变化在研究组及健康对照组间无统计学差异（P〉0.05）。结论儿童β受体功能亢进症发病年龄高峰在学龄期,尤以女性多见,心率明显增加,立位和卧位心电图T波形态和振幅变化明显。

Objective To investigate T wave and ST segment variation in 12 - lead simultaneous body surface electrocardiogram （ 12 ECG） under supine and erect position in children with beta adrenoceptor hyperfunction syndrome. Methods Twelve ECG under supine and erect position were taken from 53 cases in children with beta adrenoceptor hyperfunction syndrome[ research group：13 male,40 female;aged from 3.5 to 18 years oht, mean age （ 8.77 ＋ 2.99 ） years old ] and 40 healthy children as control group with sR - 1000A automated electrocar- diography made by Guangdong Zhongshan. Heart rate（HR） ,T wave and ST segment amplitude in 12 ECG were calculated and analyzed by SPSS 11.0 software. T wave amorphous variation was counted manually. Results 1. The age distribute peak in children with beta adrenoceptor hyperfunction syndrome was in school age,and the ratio between male and female was about 1 ： 3.2. HR under erect position significantly increased compared with supine in both groups （ P 〈 0.01 ）, and HR increased in research group was higher than that in control group [ 17.96 ＋ 10.16） times/min vs （9.67 ＋ 6.97 ） times/min ] （P 〈 0.01 ）. 3. T wave descended in lead Ⅱ , V3 , V4, V5 and V6 under erect position compared with supine position in research group,and T wave inversion occurred in lead Ⅲ and aVF and deepened in lead m, V1 and V2, and the T wave status changed from inversion in supine position to erection in erect position occurred in lead V~ and Vz. 4. T wave amplitude descending in research group was greater than that in control group in lead V1 （ P 〈 0.05 ） and lead V2 （ P 〈 0.01 ） under erect position compared with supine position. 5. ST segment amplitude had no significant change between research group and control group under erect position compared with supine position （ P 〉 0.05 ）. Conclusions The age distribute peak in children with beta adrenoceptor hyperfunction syndrome is in school age, a risk factor is likely to female children,heart rate significantly increase,T wave morphology and amplitude varied obviously as patients position change from supine to erect.