新型18导联动态心电图与常规18导联心电图图形的相关性分析

A comparative analysis of the new 18-lead ambulatory electrocardiography and the traditional 18-lead electrocardiography

摘要:

目的：评估新型18导联动态心电图记录心电信号的可靠性，探讨新型18导联动态心电图的临床价值。方法：入组41例受试者，分别接受常规18导联心电图和新型18导联动态心电图检查，获取2种检查的心电图图形，进行对比分析，包括各个导联P波振幅、QRS波形态、q波振幅、R波振幅、S波振幅、J点、ST段（J点后60 ms）偏移、T波振幅。结果：①2种检查的心电图（electrocardiography，ECG）图形相关性较高（r值在V8最大，为0.994，在V5R最小，为0.805，P<0.05）。②2种检查的ECG在q波描记上差异无统计学意义（P>0.05）。③两者各波振幅及ST段偏移的配对t检验结果，在少部分导联差异具有统计学意义（P<0.05），包括aVR、V2～V6导联上的P波振幅，V2、V9、V3R、V4R导联上的R波振幅，V3、V4、V9导联上的T波振幅，V2、V3R、V4R导联上的ST段偏移。结论：综合判断，新型18导联动态心电图记录的心电信号具有较高可靠性，在一过性心肌缺血及急性心肌梗死的诊断上，结合对应壁及相邻其他导联的指标，可提高其检查的准确性。

Abstract:

Objective：To investigate the reliability and clinical value of the new 18-lead ambulatory electrocardiography（ECG）. Methods：A total of 41 subjects were enrolled and received both traditional and new 18-lead ECG. The findings of these two ECG methods were compared in terms of P-wave amplitude，shape of QRS wave，Q-wave amplitude，R-wave amplitude，S-wave ampli－tude，J-point，ST-segment shift（60 ms after J-point），and T-wave amplitude. Results：There was a good correlation between the find－ings of these two ECG methods，with the highest correlation coefficient of 0.994 in V8 lead and the lowest correlation coefficient of 0.805 in V5R（P<0.05）. There was no significant difference in Q wave between the two ECG methods（P>0.05）. According to the re－sults of the paired t-test，there were significant differences between the two ECG methods in P-wave amplitude in aVR and V2-V6 leads，R-wave amplitude in V2，V9，V3R，and V4R leads，T-wave amplitude in V3，V4，and V9 leads，and ST-segment shift in V2，V3R，and V4R leads（P<0.05）. Conclusion：The new 18-lead ECG has higher reliability than the traditional ECG，and its combination with the parameters of other leads can improve the accuracy of the diagnosis of transient myocardial ischemia and acute myocardial infarction.