CAJ | 학술논문

　　目的探讨心电图下壁导联R波切迹对婴幼儿继发孔型房间隔缺损的诊断价值。方法观察比较162例婴幼儿继发孔型房间隔缺损（Ⅰ组）与162例无心脏疾患婴幼儿（Ⅱ组）的下壁导联R波切迹及伴不完全性右束支阻滞（RBBB）的发生率。结果Ⅰ组3个下壁导联均有R波切迹的发生率、至少1个下壁导联有R波切迹伴不完全性RBBB的发生率及3个下壁导联均有R波切迹伴不完全性RBBB的发生率分别为27.16%、14.20%、10.49%，Ⅱ组分别为3.09%、1.85%、0.62%，两组间差异均有统计学意义（P<0.005）；其诊断房间隔缺损的特异度分别为96.91%、98.15%、99.38%。结论下壁导联R波切迹是婴幼儿继发孔型房间隔缺损的一种独立的心电图征象，可以作为诊断继发孔型房间隔缺损的参考指标。
　　목적탐토심전도하벽도련R파절적대영유인계발공형방간격결손적진단개치。방법관찰비교162례영유인계발공형방간격결손（Ⅰ조）여162례무심장질환영유인（Ⅱ조）적하벽도련R파절적급반불완전성우속지조체（RBBB）적발생솔。결과Ⅰ조3개하벽도련균유R파절적적발생솔、지소1개하벽도련유R파절적반불완전성RBBB적발생솔급3개하벽도련균유R파절적반불완전성RBBB적발생솔분별위27.16%、14.20%、10.49%，Ⅱ조분별위3.09%、1.85%、0.62%，량조간차이균유통계학의의（P<0.005）；기진단방간격결손적특이도분별위96.91%、98.15%、99.38%。결론하벽도련R파절적시영유인계발공형방간격결손적일충독립적심전도정상，가이작위진단계발공형방간격결손적삼고지표。
Objectives To evaluate the values of notched on R wave in inferior leads of electrocardiogram in infant with secundum atrial septal defect. Methods To observe and compare the prevalence of notch on R wave in inferior leads combined with incomplete right bundle branch block (IRBBB) in 162 cases with secundum atrial septal defect (group I) and 162 cases without heart disease (group II). Results The prevalence of notch on R wave in all the three inferior leads, in at least one inferior lead with IRBBB and in all the three inferior leads with IRBBB were 27.16%, 14.20%and 10.49%respec-tively in group I, and were 3.09%, 1.85%and 0.62%in group II respectively, and the differences between two groups were statistically significant (P<0.005). The specificities of notch on R wave in diagnosis of atrial septal defect were 96.91%, 98.15% and 99.38% respectively. Conclusions Notch on R wave in inferior leads is an independent electrocardiographic sign of secundum atrial septal defect in infants, and thus can be used as a diagnostic parameter.