健康老年人的心电图特点

Characteristics of electrocardiograms in healthy old people

目的探讨健康老年人正常心电图特点.方法比较329例60～84岁健康老年人与1163例中青年人心电图参数.结果老年人心电图特点为:①心电图各时相延长.②P波电压增高,Pv1终末电势增大,且出现率增加.③心电轴向左(额面)、后(横面)方偏移.④R1及RaVL电压增高,RⅡ、RⅢ、RaVF、Rv5及Rv6电压降低,SaVL电压降低,而SⅢ、SavF、Sv3～5电压增大,∑QRS电压与中青年比较无明显改变.⑤T波电压普遍降低.⑥心电图参数男性＞女性,但不如中青年人显著.结论健康老年人与中青年人的心电图差异多数在诊断中可忽略不计,但Q-TLC间期、Q-Tc间期、Macruz指数(Ⅱ导联Pt/P-Rs、Morris指数(PTFv1)、心电轴及(RⅠ+SⅢ)、(RaVL+SV3)和(R Ⅱ+RⅢ)等综合电压的年龄差别较显著,诊断标准应区别于中青年.在老年人中,男性(Rv5+Sv1)及(RaVL+Sv3)综合电压＞女性,在临床诊断标准上男性与女性应有区别.

Objective To explore characteristics of electrocardiogram in healthy old people. Methods Three hundred twenty nine electrocardiograms of healthy old people aged from 60 to 84 years were compared with 1163 those of middle-aged and young people. Results Characteristics of electrocardiograms in healthy old people were as following: ① Electrocardiographic durations prolonged. ② P wave voltage increased. P wave terminal force in lead V1 raised and its presence rate gained. ③ QRS axes shifted to left(frontal plane) and posterior(horizontal plane). ④ R wave voltage increased in lead Ⅰ and aVL, and decreased in lead Ⅱ?Ⅲ?aVF?V5 and V6 . S wave voltage decreased in lead aVL, and increased in lead Ⅲ?aVF?V3?V4 and V5. No difference of ΣQRS voltage compared old persons with middle-aged and young people. ⑤ T wave voltage widespread decreased in every lead. ⑥ Parameters of electrocardiogram in male were more than that in female.Differences of them were not obvious between old persons and middle-aged and young people. Conclusion In clinical electrocardiographic parameter differences may be neglected between old people and middle-aged and young people. Diagnostic standards of following items, such as Q-TLC and Q-TC intervals, Macruz index Pt / P-RS of Ⅱ lead , Morris index PTFv1 , QRS axes, and complex voltage of RⅠ+SⅢ aVL+Sv3 and RⅡ+RⅢ, should be distinguished in old people and middle-aged and young people. Complex voltage of Rv5+Sv1 and RaVL+Sv3 in male was more than that in female, Diagnostic standard should be difference between male and female.