青年人早期复极综合征心电图特点及其影响因素

The Electrocardiogram’s Characteristics and Influencing Factors of ERS in Young People

目的探讨青年人早期复极综合征(ERS)的发生率与性别、导联分布、心率的关系及诊断和鉴别诊断.方法分析143例ERS者心电图J波及ST段变化特点及临床资料.结果 4 000例青年人共检出ERS 143例,发生率为3.58%,男性142例,占3.70%,女性1例,占0.63%;ERS随心率增快而逐渐降低,心率<60次/min的检出率最高(P<0.01);胸导联ERS发生率高于肢导联及肢导联+胸导联,差异有统计学意义(P<0.01),且差异显著.14例首次心电图可疑病例运动试验可使ST段暂时回落到基线.结论 ERS发生率男性高于女性,并随心率的增快而逐渐降低,最常见于胸导联;应结合临床病史、心电图动态观察及血清酶学改变等,与急性期心肌梗死、变异型心绞痛、心包炎等鉴别.

Objective To explore the relationship between the incidence of ERS and genders,lead distribution and heart rate,and the diagnosis and differential diagnosis of ERS.Method We analysd the changing characteristics of the J-wave and ST segment of in electrocardiograms of 143 ERS patients and the relevant clinic data.Results There were 143 people with ERS among 4000 young people,with an incidence rate of 3.58%,among them,there were 142 male patients,accounted for 3.70%,and 1 female patient,accounted for 0.63%.The incidence of ERS decreased with the speeding-up of the heart rate;the ERS incidence rate was the highest when the heart rate belows 60 bpm（P〈0.01）.The incidence rate of chest leads ERS was higher than limb leads and limb leads with chest leads（P〈0.01）.Exercising test for 14 of the electrocardiograms equivocal cases made their ST segment go down to the baseline.Conclusions The ERS incidence rate in the male is higher than the female,and decreases with the speeding-up of the heart rate.It is most common among chest leads.Combined with clinical history,observation of dynamic electrocardiograms,alterations of serum enzyme in blood and other relevant information,ERS can be identificated with acute myocardial infarction,variation line angina,pericarditis and so on.