不同胎龄新生儿同步12导联心电图QRS振幅及T波的意义

Significance of synchronous 12-lead electrocardiogram QRS amplitudes and T wave in different gestational age newborns

目的比较不同胎龄新生儿同步12导联心电图QRS振幅及T波的差异，探讨不同胎龄新生儿心电图特点，为新生儿心电图诊断提供参考依据。方法选择85例早产儿（胎龄〈37周）和60例足月儿作为研究对象，85例早产儿根据胎龄分为3组，A组（胎龄28—30周）24例，B组（胎龄31—33周）28例，C组（胎龄34～36周）33例；足月儿60例设为D组，于出生1周内对各组新生儿进行常规12导联心电图检查，对比检查结果。结果4组新生儿∑QRS肢导、RV1、RV5振幅比较差异均有统计学意义（F值分别为3．192、3．563、4．175，均P〈0．05），其中D组∑QRS肢导、RV1、RV5振幅显著高于A、B、C组，差异均有统计学意义（D组V8A组：t值分别为3．291、3．083、4．176；D组VSB组：t值分别为3．024、2．837、3．906；D组VSC组：t值分别为2．718、2．552、2．683；均P〈0．05）；C组∑QRS肢导、RV，振幅显著高于A组，差异均有统计学意义（t值分别为2．251、2．073，均P〈0．05）。4组新生儿TV1、TV5振幅比较差异均有统计学意义（F值分别为5．284、5．106，均P〈0．05），其中D组TV1、TV5振幅显著高于A、B、C组。差异均有统计学意义（D组VSA组：t值分别为3．028、3．275；D组 vs B组：t值分别为3．008、2．984；D组VSC组：t值分别为2．865、2．775；均P〈0．05）；C组TV1、TV5振幅显著高于A、B两组，差异均有统计学意义（C组VSA组：t值分别为2．653、2．732；C组 vs B组：t值分别为2．361、2．463；均P〈0．05），B组TV1、TV5振幅显著高于A组，差异有统计学意义（t值分别为2．295、2．093；均P〈0．05）。结论随着胎龄的增加，新生儿12导联心电图QRS振幅及TV1、TV5振幅显著增加，新生儿早期心电图检查应该遵循胎龄标准参数，以便获得正确的诊断结果。

Objective To compare the synchronous 12-lead electrocardiogram QRS amplitudes and T wave and to explore the electrocardiogram characteristics in different gestational age newborns, so as to provide reference for newborn electrocardiogram diagnosis. Methods Research subjects included 85 cases of premature infants （ gestational age 〈 37 weeks ） and 60 full term newborns. The premature infants were divided into 3 groups according to gestational age, 24 cases in group A （ 28 - 30 gestational weeks） , 28 cases in group B （31 -33 gestational weeks） and 33 cases in group C （34 -36 gestational weeks）. Sixty cases of full term were set in group D. Routine 12-lead electrocardiogram examination was performed within one week after birth for each newborn and test results were compared. Results The differences in ∑ QRS limb lead, RV1 and RV5 amplitude among four groups were statistically significant （F value was 3. 192, 3. 563 and 4. 175, respectively, all P 〈0.05）. In group D the ∑QRS limb lead, RV1 and RV5 amplitude were higher than those in other three groups, and the differences were significant （tA value was 3. 291,3. 083 and 4. 176, tB value was 3. 024, 2. 837 and 3. 906, tC value was 2.718, 2. 552 and 2. 683, respectively, all P 〈 0.05 ）. The ∑ QRS limb lead and RV1 amplitude in group C were significantly higher than those in group A, and the differences were statistically significant （ t value was 2.251 and 2. 073, respectively, both P 〈 0.05 ）. The differences in TV1 and TV5 amplitude among four groups were significant （ F value was 5. 284 and 5. 106, respectively, both P 〈 0.05 ）. The TV1 and TV5 amplitude in group D were significantly higher than those in other three groups, and the differences were significant （tA value was 3. 028 and 3. 275 ,ts value was 3. 008 and 2. 984, tc value was 2. 865 and 2. 775, respectively, all P 〈 0.05 ）. The TV1 and TV5 amplitude in group C were significantly higher than those in group A and group B （ tA value was 2. 653 and 2. 732 ,tB value was 2. 361 and 2.463, respectively, all P 〈 0.05 ）. In group B TV1 and TV5 amplitude were higher than those in group A with significant differences （t value was 2. 295 and 2. 093, respectively, both P 〈 0.05 ）. Conclusion With the increase of gestational age, synchronous 12-lead electrocardiogram QRS amplitudes, TV1 and TV5 amplitude increase remarkably. In order to get correct diagnosis, early newborn electrocardiogram examination should follow gestational age standard parameters.