CAJ | 학술논문

目的调查和评估我国成人健康人群心电图的正常范围.方法采集5360例(男性3614例,女性1746例,年龄范围18～84岁)健康人12导联同步心电图并按性别分为5个年龄组,计算和分析男、女各年龄组心电图参数的中位数及96%范围的正常上、下限,并比较其年龄和性别差异.结果 PR间期、QTc间期、额面QRS电轴呈现明确的年龄趋势(P＜0.001).PR间期、QRS波时限、QTc间期及不同导联QRS波和T波振幅存在明显的性别差异(P＜0.001).男性PR间期上限值约为200 ms,女性PR问期上限值从180ms随年龄增长逐渐增加到200 ms.男性QRS波时限上限值为120 ms,女性为109 ms.各年龄组男、女性QTc间期上限值均＞440 ms,女性QTc间期＞440 ms的发生率(12.8%)明显高于男性(6.2%).男性QRs电轴的正常范围为-37°～+94°,女性为-27°～+91°.Q波时限正常范围有明确的导联依赖性.在胸前导联,男性T波幅度的正常值不超过1.44 mV,女性不超过0.9 mV;在肢体导联,男性不超过0.54 mV,女性不超过0.45 mV.值得注意的是,肢体导联QRS振幅随年龄增长的变化规律与额面QRS电轴随年龄增长逐渐向左(上)偏移相一致;女性V5导联的R波振幅随年龄增长而增加.结论我国成人健康人群心电图参数存在明显的年龄及性别差异,适当调整传统的正常标准,可望进一步提高心电图诊断的质量.
목적 조사화평고아국성인건강인군심전도적정상범위.방법 채집5360례(남성3614례,녀성1746례,년령범위18～84세)건강인12도련동보심전도병안성별분위5개년령조,계산화분석남、녀각년령조심전도삼수적중위수급96%범위적정상상、하한,병비교기년령화성별차이.결과 PR간기、QTc간기、액면QRS전축정현명학적년령추세(P＜0.001).PR간기、QRS파시한、QTc간기급불동도련QRS파화T파진폭존재명현적성별차이(P＜0.001).남성PR간기상한치약위200 ms,녀성PR문기상한치종180ms수년령증장축점증가도200 ms.남성QRS파시한상한치위120 ms,녀성위109 ms.각년령조남、녀성QTc간기상한치균＞440 ms,녀성QTc간기＞440 ms적발생솔(12.8%)명현고우남성(6.2%).남성QRs전축적정상범위위-37°～+94°,녀성위-27°～+91°.Q파시한정상범위유명학적도련의뢰성.재흉전도련,남성T파폭도적정상치불초과1.44 mV,녀성불초과0.9 mV;재지체도련,남성불초과0.54 mV,녀성불초과0.45 mV.치득주의적시,지체도련QRS진폭수년령증장적변화규률여액면QRS전축수년령증장축점향좌(상)편이상일치;녀성V5도련적R파진폭수년령증장이증가.결론 아국성인건강인군심전도삼수존재명현적년령급성별차이,괄당조정전통적정상표준,가망진일보제고심전도진단적질량.
Objective To investigate the normal limits of the electrocardiogram(ECG) in healthy Chinese subjects. Methods Standard simultaneous 12-lead ECG firm 5360 apparently healthy Chineso(3614 men and 1746 women,ages ranging from 18 to 84 years)were collected with a modem digital recorder and processed with a well-validated ECG computer program. The medians, lower limits(2nd percentile)and upper limits (98th percentile)of various ECG measurements were calculated and age and sex differences examined. Results Significant age trends were present in PR interval,QTc interval and frontal QRS axis(P <0.001 ). Sex differences existed for PR interval,QRS durations,QTc interval and QRS and T amplitudes in different leads( P <0.001 ).The upper limit of the PR interval was about 200 ms in men and in women, the upper limit gradually increased with age from 180 ms to 200 ms. The upper limit of QRS duration was about 120 ms for men and 109 ms for women. The prevalence of QTe > 440 ms was 12. 8% ( 223/1746 ) in women and 6. 2% ( 223/3614 ) in men. Normal limits of the frontal QRS axis was -37° ～ +94° for men and -27°～ +91° for women. Normal limit of Q-wave duration was markedly lead-dependent. The upper normal limits of T wave amplitude in limb leads was 0.54 mV for men and 0.45 mV for women,and in precardial leads 1.44 mV for men and 0.9 mV for women. Notably,the changes of R-wave amplitudes in limb leads were concomitant with a frontal QRS axis shift to the left with age;the left-precordial R-wave amplitudes in women increased with age. Conclusions Normal ECG limits of healthy Chinese population show marked age and sex differences. Tuning of some traditional criteria may further improve the accuracy of ECG diagnosis.