健康婴幼儿及儿童心电图时间参数的比较

Comparison on Electrocardiographic Time Parameter in Healthy Infants and Children

目的比较不同年龄和性别健康婴幼儿及儿童心电图(ECG)时间参数的特点,评估现有国内外健康婴幼儿及儿童ECG标准应用于我国儿童的可行性。方法记录上海地区1557名健康婴幼儿和儿童(男812例,女745例;年龄1～17岁)ECG的心率(HR)、P波时间、P-R间期、QRS波时间、Q-T间期、Q-R峰值时间,并在不同年龄组及男女组间进行比较。结果HR、P波时间、P-R间期、QRS波时间、Q-T间期、校正Q-T间期(QTc)、QT离散度(QTd)及Q-R峰值时间在各年龄组间均有显著性差异(Pa<0.001),P波时间、P-R间期、QRS波时间及Q-T间期均与年龄呈正相关,与HR呈负相关(Pa<0.001)。部分测量值男女组间以及与既往标准间的差异均有统计学意义(Pa<0.05)。结论健康婴幼儿及儿童ECG时间参数具有年龄、性别、时间和种族差异。沿用传统的国内外健康婴幼儿及儿童ECG标准不合适,有必要修订更新传统的正常值标准,并应重视年龄、性别间的差异。与之相关的疾病诊断标准也应进行修订。

Objective To evaluate the age - and sex - dependent trends of selected time parameter of electrocardiography （ECG） variables in healthy infants and children and compare some normal limits with available data from previous studies. Methods Standard 12 - lead ECG from 1 557 heathly infants and children（812 boys and 745 girls,aged 1 day to 17 years）living in Shanghai were recorded. Heart rate （HR） , P- wave duration ,P- R interval, QRS- wave duration, QT interval, and Q- R peak time were recorded and compared between the groups of different ages and sex. Results Significant age - dependent differences were present in HR, P - wave duration, P - R interval, QRS - wave duration, QT interval, correct QT interval（ QTc ）, QT dipersion （QTd） and Q - R peak time （Pa 〈 0. 001 ）. P - wave duration, P - R interval, QRS - wave duration and QT interval had positive correlation with the age and negative correlation with HR（ Pa 〈 0. 001 ）. Compared with previous studies, significant differences were present in some parameters and so were gender differences （ Pa 〈 0.05 ）. Conclusions Normal ECG time parameter limits of infants and children show significant age, sex, time and race of people differences. Previous normal limits are unsuitable now and should be revised and updated. It is essential to establish a up - to - date age - and sex - specific limits for some time parameter measurements. Some criterions of disease based on ECG should be revised.