70岁以上健康老年人右胸及后壁导联心电图特点分析

Electrocardiogram characteristics of right and posterior chest leads in healthy old people

目的研究70岁以上健康老年人右胸及后壁导联心电图特点。方法对212例70岁以上健康老年人右胸及后壁导联的P波、QRS波及ST段进行形态观察及测量分析。结果(1)右胸导联rS波形检出率为31.1%～58.1%;QS波形检出率为14.0%～23.3%;V4R导联(QS波除外)、V5R导联各波振幅低于V3R导联(P<0.05);(2)后壁V7～V9导联qR波形检出率为50.0%～87.7%;R波形检出率为7.1%～34.9%;与V7导联比较,V8、V9导联qR波形的出现率递增,R波形出现率及R波振幅均呈现递减(P<0.05);(3)ST段:V3R～V5R导联97.5%～98.9%位于等电位线;V7～V9导联97.2%～98.5%位于等电位线;极少数抬高者幅度<0.05mV,无ST段下降;(4)T波:V3R～V5R导联61.3%～79.2%为平坦,21.8%～25.8%为倒置;V7～V9导联45.1%～78.5%为平坦,20.0%～53.7%为直立。结论建立70岁以上老年人右胸及后壁导联心电图的诊断标准具有实际的临床意义。

Objective To study electrocardiogram characteristics of right and posterior chest leads in healthy old people over 70 years. Methods Electrocardiograms of V3R to V5R and V7 to V9 leads were taken from 212 healthy old people over 70 years. P waves, QRS waves, ST segment and T waves were measured and analyzed. Results （1） From V3R to VsR leads, rS wave was found in 31.1%-58.1% QS wave was found in 14.0%-23.3%. The voltage of QRS wave was lower in V4R and V5R than in V3R leads （P〈0. 05）. （2） From V7 to V9 leads ,qR wave was found in 50.0%--87.7% jR wave was found in 7.1%-34.9%. The voltage of R waves decreased from V7 to V9 leads （P 〈0.05）. （3） ST segment elevation by the voltage 〈0.05 mV was seldom found in V3R to V5R and V7 to V9 leads. There was no ST segment depression in V3R to V5R and V7 to V9 leads. （4） In V3R to V5R leads, smooth T waves were found in 61.3%-79.2%,negative T waves were found in 21. 8%- 25. 8%. In V7 to V9 leads, smooth T waves were found in 45. 1%-- 78.5%,positive T waves were found in 20.0%-53.7%. Conclusion It is meaningful to set up the electrocardiogram diagnosis criteria special for the old people.