CAJ | 학술논문

目的初步探讨健康成人心电图窦性P波、QRS波群、T波、U波的横面及空间心电轴的测量方法和正常参考范围。方法连续入选住院体检确定的100例健康成人（男性组，n=50；女性组，n=50）的12导联同步心电图进行分析，测量V6和V1的窦性P波、QRS波群、T波、U波振幅的代数和，借助测算额面QRS波群心电轴的查表法和坐标绘图法来确定相应心电波的横面心电轴。根据窦性P波、QRS波群、T波、U波的额面和横面心电轴所在方位确定相应心电波的空间心电轴所在方位。结果男性组、女性组和全组的窦性P波横面心电轴分别为+30.00o~+77.92o（+58.00o）、+30.26o~+75.00o（+60.00o）和+30.00o~+75.00o（+60.00o）；窦性QRS波群横面心电轴分别为-40.50o~+36.70o（-1.90o±19.70o）、-31.80o~+42.20o（+5.20o±18.90o）和-36.72o～+40.12o（+1.70o±19.60o）；窦性T波横面心电轴分别为+10.20o~+70.94o（+53.00o）、-7.80o~+62.78o（+41.00o）和+2.06o~+68.00o（+45.00o）；窦性U波横面心电轴分别为+37.04o~+81.00o（+60.00o）、+8.00o~+89.82o（+50.00o）和+8.44o~+81.00o（+60.00o）。男、女性组间只有窦性T波横面心电轴差异有统计学意义（P＜0.01）。男性组、女性组和全组窦性P波和T波的空间心电轴100%均在左前下象限；窦性QRS波群空间心电轴99%均在左前下或左后下象限；窦性U波空间心电轴93%均在左前下象限，男、女性组间差异无统计学意义（均P＞0.05）。结论上述结果可供进一步确定成人窦性P波、QRS波群、T波、U波横面和空间心电轴的正常范围和临床应用参考，其测量方法是否合理尚待进一步验证。
목적초보탐토건강성인심전도두성P파、QRS파군、T파、U파적횡면급공간심전축적측량방법화정상삼고범위。방법련속입선주원체검학정적100례건강성인（남성조，n=50；녀성조，n=50）적12도련동보심전도진행분석，측량V6화V1적두성P파、QRS파군、T파、U파진폭적대수화，차조측산액면QRS파군심전축적사표법화좌표회도법래학정상응심전파적횡면심전축。근거두성P파、QRS파군、T파、U파적액면화횡면심전축소재방위학정상응심전파적공간심전축소재방위。결과남성조、녀성조화전조적두성P파횡면심전축분별위+30.00o~+77.92o（+58.00o）、+30.26o~+75.00o（+60.00o）화+30.00o~+75.00o（+60.00o）；두성QRS파군횡면심전축분별위-40.50o~+36.70o（-1.90o±19.70o）、-31.80o~+42.20o（+5.20o±18.90o）화-36.72o～+40.12o（+1.70o±19.60o）；두성T파횡면심전축분별위+10.20o~+70.94o（+53.00o）、-7.80o~+62.78o（+41.00o）화+2.06o~+68.00o（+45.00o）；두성U파횡면심전축분별위+37.04o~+81.00o（+60.00o）、+8.00o~+89.82o（+50.00o）화+8.44o~+81.00o（+60.00o）。남、녀성조간지유두성T파횡면심전축차이유통계학의의（P＜0.01）。남성조、녀성조화전조두성P파화T파적공간심전축100%균재좌전하상한；두성QRS파군공간심전축99%균재좌전하혹좌후하상한；두성U파공간심전축93%균재좌전하상한，남、녀성조간차이무통계학의의（균P＞0.05）。결론상술결과가공진일보학정성인두성P파、QRS파군、T파、U파횡면화공간심전축적정상범위화림상응용삼고，기측량방법시부합리상대진일보험증。
Objective To explore measurement methods and normal reference range of P, QRS, T and U- wave horizontal and spatial axis in healthy adults. Methods The standard simultaneous 12-lead electrocardiograms (ECGs) of 100 healthy Chinese adults (50 men and 50 women, ages ranging from 23 to 58 years) were analyzed. The horizontal axis of P, QRS, T, and U- wave was calculated by the algebraic sum of amplitudes of the corresponding waves in V6 and V1 leads. The spatial axis of P, QRS, T and U- wave was determined by frontal and horizontal axis. Results In male, female and whole group, the sinus P-axis in horizontal plane was +30.00o~+77.92o(+58.00o), +30.26o~ +75.00o(+60o) and +30.00o~+75.00o(+60.00o) respectively;the sinus QRS-axis was-40.50o~+36.70o(-1.90o±19.70o),-31.80o~+42.20o(+5.20o±18.90o) and -36.72o~+40.12o(+1.70o±19.60o) respectively;the sinus T-axis was +10.20o~ +70.94o(+53.00o), -7.80o~+62.78o(+41.00o) and +2.06o~ +68.00o(+45.00o) respectively; the sinus U- axis was +37.04o~+81.00o(+60.00o),+8.00o~+89.82o(+50.00o) and +8.44o~+81.00o(+60.00o) respectively. The only significant difference between male and female group was horizontal T-axis (P<0.01). The spatial axis of al sinus P and T wave was located in left anterior-inferior quadrant, 99%sinus QRS wave in left anterior-inferior or left posterior-inferior quadrant and 93%sinus U wave in left anterior-inferior quadrant. There was no significant difference between male and female group (P>0.05). Conclusion This study provides reference values of horizontal and spatial axis of sinus P, QRS, T and U-wave in healthy adults. The reasonability of the measurement methods needs to be tested and verified.