心向量图与心电图的Q—T间期离散度比较分析

目的应用心向量图和12导联心电图对比分析Q—T间期离散度（Q—Td）。方法使用Metronics心电工作站分别对确诊的心肌梗死组100例（其中心电图ST—T正常和异常者各50例）、正常组100例、对照组50例（心电图ST—T均异常）行同步12导联心电图（D1）、心向量图（正交心电图,D2）和时间心向量图（D3）检测,并测定和比较Q—Td。结果心肌梗死组中ST-T异常者D1（27．49±25．32）ms,明显大于D2（7．35±13．01）ms和D3（1．56±4．08）ms（均P〈0．01）：正常组D1（15．72±15-71）ms,明显大于D2（1．22±4．7）ms、D3（1．60±4．92）ms（均P〈0．01）;对照组D1（46．37±23．80）ms,亦明显大于D2（16．88±20．56）ms和D3f4．334-9,47）ms（均P〈0．01）。心肌梗死组无ST-T改变者D2、D3与对照组比较,差异无统计学意义（均P〉0．05）。而D1则有统计学意义（P〈0．05）。结论测量方法可影响Q-Td的大小,12导联心电图Q—Td的增大与ST—T改变有关。

Comparison of Q-T dispersion between 9-vectorcardiogram and 12-electrocardiogram

Objective To investigate factors influencing Q-T dispersion（Q-Td） by vectorcardiogram（VCG）. Methods 50 patients with myocardial infarction （MI） and abnormal ST-T, 50 patients with MI and normal ST-T, 50 patients with abnormal ST-T and 100 healthy persons were included. Q-Td was measured on 12-electrocardiogram（ D1 ）, 9-lead VCG （D2） and timed VCG （D3） recorded synchronously. Results Dll27.49±25.32 ms, 46.37±23.80 ms, 15.72± 15.71ms） was significantly greater than D2 （ 7.35 ±13.01 ms, 16.88 ± 20.56 ms, 1.22 ± 4.7 ms ） and D3 （ 1.56 ± 4.08 ms, 4.33±9.47 ms, 1.60 ± 4.92 ms） in patients with CAD and abnormal ST-T, patients with abnormal ST-T and healthy persons （all P 〈 0.01 ）, respectively. D1 was significantly greater in healthy persons than in patients with MI and normal ST-T. There was no significant difference of D2 and D3 between them. Conclusion Different methods may influence measurements of Q-Td. Abnormal ST-T increases Q-Td on 12-electrocardiogram.