CAJ | 학술논문

目的：观察双源性并行心律的心电散点图特征，探讨其鉴别诊断的意义。方法：选择已明确诊断的7例双源性并行心律患者的心电散点图资料进行回顾性分析，分别与单源性早搏、双源性早搏及单源性并行心律的心电散点图特征进行对比。结果：共分为6组（每组各7例），其特征是：1组（单源性房性早搏），呈三分布，窦性节律位于45°线上；2组（双源性房性早搏）呈五分布，窦性节律位置不变，早搏前后点分别位于其两边，图形对称呈双分布，1、2组B线斜率均在0-1之间，其斜率无显著差异（P＞0.05）；3组（单源性室性早搏），呈四分布图形，窦性节律位于45°线上，早搏前后点分别趋向平行于X、Y轴，4组（双源性室性早搏）呈六分布，窦性节律位置不变，与单源性室早不同之处在于，其早搏前后点呈对称双分布，3、4组B线斜率均趋向于0，其斜率也无显著差异（ P＞0.05）；5组（单源性并行心律）图形特征为沿垂直于45°线的四分布图形，早搏点集垂直于45°线，早搏前点、后点集分别垂直于X、Y轴；6组（双源性并行心律）图形为沿垂直于45°线的七分布图形，图形与单源性并行心律相似，5、6组间B线斜率均趋向于∞，无显著差异（P＞0.05），不同之处在于呈双分布；5、6组B线斜率明显大于1、2组[（∞）比（4.78±0.19）]，1、2组B线斜率又显著大于3、4组（0.36±0.06）， P均＜0.01。结论：双源性并行心律心电散点图特征与单源性并行心律，单（双）源性房、室早搏图形均有显著差异，有助于并行心律的鉴别诊断。
목적：관찰쌍원성병행심률적심전산점도특정，탐토기감별진단적의의。방법：선택이명학진단적7례쌍원성병행심률환자적심전산점도자료진행회고성분석，분별여단원성조박、쌍원성조박급단원성병행심률적심전산점도특정진행대비。결과：공분위6조（매조각7례），기특정시：1조（단원성방성조박），정삼분포，두성절률위우45°선상；2조（쌍원성방성조박）정오분포，두성절률위치불변，조박전후점분별위우기량변，도형대칭정쌍분포，1、2조B선사솔균재0-1지간，기사솔무현저차이（P＞0.05）；3조（단원성실성조박），정사분포도형，두성절률위우45°선상，조박전후점분별추향평행우X、Y축，4조（쌍원성실성조박）정륙분포，두성절률위치불변，여단원성실조불동지처재우，기조박전후점정대칭쌍분포，3、4조B선사솔균추향우0，기사솔야무현저차이（ P＞0.05）；5조（단원성병행심률）도형특정위연수직우45°선적사분포도형，조박점집수직우45°선，조박전점、후점집분별수직우X、Y축；6조（쌍원성병행심률）도형위연수직우45°선적칠분포도형，도형여단원성병행심률상사，5、6조간B선사솔균추향우∞，무현저차이（P＞0.05），불동지처재우정쌍분포；5、6조B선사솔명현대우1、2조[（∞）비（4.78±0.19）]，1、2조B선사솔우현저대우3、4조（0.36±0.06）， P균＜0.01。결론：쌍원성병행심률심전산점도특정여단원성병행심률，단（쌍）원성방、실조박도형균유현저차이，유조우병행심률적감별진단。
Objective:To observe the feature of Lorenz plots of dual parasystole ,and explore its differential diagnosis significance .Methods :Lorenz plot data of seven patients diagnosed as dual parasystole was retrospectively analyzed . They were compared with those of single source premature beat ,dual premature beat and single source parasystole . Results :All case data were divided into six groups (seven cases in each group) ,its features were :group 1 [ (single source atrial premature beat (APB)] ,plots were characterized with three distribution and sinus rhythm located on 45° line ;group 2 (dual source APB) were five distribution with the same sinus rhythm location ,the points set before and after premature were located on its two sides ,the plot was symmetry ,slopes of line B were within 0~1 in group 1 and 2 and its slopes were no significant difference (P>0.05);group 3 was single source ventricular premature beat (VPB) ,show four distribution pattern ,sinus rhythm was located on 45° line ,the points set before and after prema-ture were almost parallel to X and Y axis ;group 4 ( dual source VPB) were in six distribution with the same sinus rhythm location ,its difference with single source VPB was the points set before and after premature were symme-try;slopes of line B all trends to 0 in group 3 and 4 ,their slope also no significant difference (P>0.05);Group 5 (single source parasystole ) was characterized as four distribution vertical to 45° line ,premature point set was vertical to 45° line ,point set before and after premature were vertical to axis X and Y respectively ;group 6 (dual parasysto-le) were seven distribution vertical to 45° line ,were similar to that of single source parasystole ,the difference was figure of group 6 was dual distribution ;slopes of line B were close to ∞ in group 5 and 6 ,and its difference were no significant (P>0.05) .The line B slopes in group 5 and 6 were significantly higher than those of group 1&2 [ (∞ ) vs .(4.78 ± 0.19)] ,and those of group 1&2 were significantly higher than those of group 3&4 (0.36 ± 0.06) ,P<0.01 all .Conclusion:There are significant difference in Lorenz plot features among single (dual) source atrial/ven-tricular premature beats ,single source parasystole and dual parasystole .Lorenz plot is helpful to differential diagno-sis of parasystole .