运动性QRS波高频电压改变及临床意义

本文探讨运动性ＱＲＳ波高频电压改变及临床意义，３６例心肌梗死，４５例心绞痛，５２例胸闷，５７例康复者及４８例正常人，共２３８例，分别于于运动前后进行了常规心电图和高频心电图检测。运动后，常规心电图有改变者很少，而高频心电图每例都有明显改变；ＱＲＳ波高频电压，在冠心病患者中是下降的，在正常中是上升的，两者差异非常显著。这表明，运动性ＱＲＳ波高频电压改变，可作为心肌是否缺血的参考指标，其敏感性高达１０     

75例老年冠心病患者高频心电图分析

７５例老年冠心病患者高频心电图分析吴振国，施志明，周晓美，安玉贵高频心电图是在常规心电图基础上发展起来的一项心脏无创性检查技术。尽管在心电图ＱＲＳ波群中高频成分不到３％，但它却携带了一些早期病变的信息，提高了心电图的诊断价值［ＡｂｂｏｌｉｄＳ．Ｐｒｏ...     

208例高频心电图的初步分析

高频心电图 (ＨＦＥＣＧ)是 1种快速而细小的电信号 ,目前主要分析出现在ＱＲＳ波上的高频成份 ,表现为切迹、扭结、顿挫 ,能显示常规心电图不能反映的高频信号。目前人们已认识到远在常规心电图发生异常以前 ,ＨＦＥＣＧ就已经显示了许多心脏疾病的早期信息。文献报道它对冠心病、高血压病等疾病及病变程度的评价有一定的作用[1 ] 。分析如下。1　资料与方法2 0 8例均为临床上有完整资料的门诊或住院病人 ,男 12 4例、女 84例 ,年龄5～ 83岁。以冠心病、高血压病、心肌炎等疾病为主。采用北京美高仪ＥＣＧＬａｂ2 0版本心电综合分析系统。…     

860例老年人健康普查心电图分析

1　资料与方法860例老年人为 1999年我院健康普查人员。年龄 >65岁 ,平均 73岁。有原发性高血压 76人 ,冠心病 65人。2　结果表 1　 860例老年人健康普查心电图改变情况心电图改变 ＳＴ -Ｔ显著改变 心律失常 ＱＲＳ高电压 Ｐ波改变 异常Ｑ波或ＱＳ波异常数 2 84 2 53 12 9776 7异常率 3 3 0 2 % 2 9 4 1% 15% 8 95% 7 79?0例中异常心电图 5 3 4例 ,单纯ＳＴ-Ｔ改变者 5 3例 ,合并其他异常改变 2 3例 ;单纯心律失常者 2 5 3例 ,合并其他异常改变 15 3例 ,其中传导阻滞 92例 ,单纯ＱＲＳ波高电压 2 7例 ,合并其他异常改变10 2例 ;单纯Ｐ波…     

12导联心电图QRS波群总电压对高血压左室肥厚的诊断意义

１２导联心电图ＱＲＳ波群总电压对高血压左室肥厚的诊断意义中国人民解放军第八六医院内科张成义，戴崇宽，胡海波，杨欲晓心电图对左室肥厚（ＬＶＨ）的诊断敏感性、特异性均较差。本文测定了８７例高血压患者１２导联心电图ＱＲＳ波群的总电压，并与心电图诊断ＬＶＨ的...     

运动试验QRS波变化诊断冠心病研究进展

近年来 ,运动试验ＱＲＳ波变化日益受到重视 ,且作为诊断冠心病 (ＣＨＤ)的一项指标具有重要临床意义 ,本文综述其研究进展。1　ＱＲＳ间期变化1 .1 　ＱＲＳ间期延长且与冠状动脉 (冠脉 )狭窄支数直接相关运动试验诱发ＣＨＤ患者心肌缺血时 ,心电图ＱＲＳ波变化为时限延长〔1〕。Ｍｉｃｈａｅｌｉｄｅｓ等〔2〕 观察了330例疑诊ＣＨＤ患者运动试验ＱＲＳ波时限改变 ,并与选择性冠脉造影 (ＣＡＧ)结果对照 ,结果表明 :ＣＡＧ正常者运动试验后ＱＲＳ波时限缩短 ;而冠脉显著狭窄者运动试验后ＱＲＳ延长且延长值与狭窄冠脉支数直接正相关 ,另一…     

小儿12导联QRS总振幅正常值及对先心病左室肥大的诊断价值

观察１４０例健康儿童（２８天－１４岁）及１２０例先心病患儿的心电图１２导联ＱＲＳ总振幅（ΣＱＲＳ）。健康儿童ΣＱＲＳ的９５％正常值范围为１４０－２５０ｎｍ。以ΣＱＲＳ〉２５０ｍｍ为诊断儿童左室肥大标准，对先心病并左室肥大诊断的敏感性为８３．３３％，特异性为９７．８６％，准确性为９１．１５％，与其他心电图指标比较，特异性相近，而敏感性及准确性明显提高，认为ΣＱＲＳ是一项诊断儿童先心病并左室肥大的新指     

QRS波增宽的老年心肌梗塞患者预后分析：附31例报告

报道３１例老年心肌梗塞伴ＱＲＳ波增宽患者的预后，其中急灶心梗１３例、陈旧性心埂１８例，均有较频繁的心绞痛。较多病例心电图表现为Ｉ、ａＶＬ、Ｖ５、Ｖ６或（和）Ⅱ、Ⅲ、ａＶＦ导联上ｑ和Ｓ波变小，消失，Ｒ波增宽、有挫折并振幅减小。ＱＲＳ波比梗塞前或心绞痛前ＱＲＳ间期增宽３０％～４９％１１例、５０％～９９％１８例、≥１００％２例。死亡２９例。急性心梗前后出现ＱＲＳ增宽的１３例发病后两周内均死亡。另外，本组患者心衰和粹死率高。说明心梗伴ＱＲＳ增宽≥３０％者预后险恶。     

右前间隔旁束可改变QRS终末向量

为了确定某些部位的预激综合征是否可引起ＱＲＳ终末向量改变。对６例右前间隔旁束病人射频消融前后的休表心电图作自身对照研究。结果；发现右前间隔旁束引起ＱＲＳ终末向量改变的５例，主要在Ｉ，ａＶＬ及Ｖ４－６导联使终末Ｒ波变为终末Ｓ波。在ａＶＲ导联使终末Ｓ波变为终末ｒ波。     

心电图酷追认正后壁心肌梗死2例

例１,男性,４８岁。体检心电图：肢体导联无异常,Ｖ１导联Ｒ／Ｓ＝１,Ｒｖ１　 ０．６ｍＶ,Ｒｖ５ ２．０ｍＶ,Ｖ３导联呈Ｒｓ型,Ｒ／Ｓ＞１。ＳＴ段无偏移,Ｔ波正常。Ｖ８～９导联Ｑ波电压等于后继Ｒ波的１／４,时间０．０３ｓ,ＳＴ段无偏移,Ｔ波低平。疑为陈旧性正后壁心肌梗死,心电向量横面ＱＲＳ环呈逆转,右前向量稍增大,整个ＱＲＳ波环体在左前左后展开。诊断：心脏呈逆钟向转位。超声心动图检查：心室后壁无节段性运动异常。 例２．男性,７２岁。近２年时有心悸气短,查心电图Ｖ１导联 ＱＲＳ波群里 Ｒ型,Ｒｖ１ １．…     

Comparison of the Sensormedics® 3100A and Bronchotron® transporter in a neonatal piglet ARDS model

The Sensormedics® 3100A (Cardinal Health, Dublin, OH) (HFOV) and the Bronchotron® (Percussionaire, Sandpoint, ID) (HFPV) are high‐frequency ventilation devices used to support neonatal respiratory failure; however, a comparison of the devices, with respect to gas exchange at similar ventilator settings, has not been previously studied. Thus, we compared the ability of HFOV to that of HFPV to provide oxygenation and ventilation during acute lung injury in a newborn animal model. Using a saline lung lavage model, 12 neonatal piglets were randomized to initial support with either the HFOV or HFPV with settings adjusted to achieve PaCO₂ of 45–60 mmHg. After stabilization, ventilator settings and arterial blood gases were serially recorded for 30 min. Animals were then crossed over to the alternative device set to deliver the same V_t, MAP, and F for an additional 30 min with the same parameters recorded. We found that the ΔP needed to generate adequate V_t on HFPV (35 ± 7 cmH₂O) trended higher versus HFOV (31 ± 7 cmH₂O P = 0.09) when the devices were matched for V_t, F, and MAP. No significant differences in ventilation (PaCO₂ = 50 ± 10.7 mmHg vs. 46 ± 10 mmHg, P = 0.22) or oxygenation (PaO₂ = 150 ± 76 mmHg vs. 149 ± 107 mmHg, P = 0.57) between the devices were found. We conclude that HFPV ventilates and oxygenates as well as HFOV at equivalent ventilator settings. HFPV may require larger ΔP's to generate equivalent V_t. Pediatr Pulmonol. 2009; 44:693–700. © 2009 Wiley‐Liss, Inc.     

In vitro and in vivo comparison of three different intravascular ultrasound catheter designs.

Intravascular ultrasound (IVUS) is an invasive imaging modality, which provides detailed two-dimensional images of blood vessels. There are currently two different types of IVUS catheters available, namely, the phased-array and the mechanical designs. The operating ultrasound frequency of these catheters ranges from 20 to 40 MHz. This study sought to evaluate the image quality, accuracy of diameter and pullback length measurements, and catheter handling characteristics of three different IVUS catheters currently available for clinical use using both in vitro phantom models and in patients undergoing percutaneous coronary intervention (PCI). In gelatin phantom models, image quality assessed on a semiquantitative scale was significantly different between the three IVUS catheters (P = 0.01) with the 40-MHz catheter providing the best images. Accuracy of lumen diameter measurements, when compared to optical microscopy, were similar between the three IVUS catheter designs (all R(2) = 0.99). There were no significant differences in accuracy of pullback length measurements in vitro between the three designs. However, there were differences in the performance of the three IVUS catheters when used for preinterventional imaging in patients undergoing PCI. Both mechanical IVUS catheters were associated with lower procedural, fluoroscopy, and lesion crossing times compared to the phased-array catheter (all P < 0.05). There were no significant differences between the catheters during postinterventional IVUS imaging. There were also small but potentially important differences with regards to clinical events and complications associated with the use of the different IVUS catheters during the PCI procedures, reflecting differences in catheter design.     

180例正常人高频心电图分析

为探讨正常成人的高频心电图表现,对180例正常人作X、Y、Z导联高频心电图研究。结果显示:切迹数1.28±0.94个,扭结数2.74±1.72个;如以切迹数≥3个为阳性标准;阳性率为7.22％。同时还显示:正常人切迹数和扭结数与性别、年龄无关。     

经电子纤支镜高频电刀治疗气道阻塞性疾病的临床研究

目的探讨经电子支气管镜高频电刀治疗气道阻塞性疾病的疗效及安全性。方法对25例气道阻塞性疾病，经电子支气管镜高频电刀切除、电灼扩大管腔，观察疗效及并发症。结果24例（96％）患者解除了气道阻塞，呼吸困难缓解，反复感染消除。高频电刀治疗时发生心跳骤停1例。结论经电子支气管镜高频电刀治疗气道阻塞性疾病疗效好、并发症少，可替代部分外科手术，值得临床广泛应用。     

用高频心电图观察麝香保心丸对家兔急性心肌缺血的影响

作者用高频心电图观察麝香保心丸对家兔急性心肌缺血的影响，以探讨麝香保心丸的药理作用。结果表明，麝香保心丸能明显减少急性心肌缺血时高频切迹数（Ｐ＜０．０１）。提示本药有一定的抗心肌缺血作用，其细胞电生理作用，有待进一步探讨     

药物电火花疗法治疗颈性眩晕的临床观察

目的　研究药物电火花疗法治疗颈性眩晕的机理及临床疗效。方法 :随访 1996年 10月～ 2 0 0 0年 10月采用药物电火花治疗的 114例颈性眩晕患者进行系统回顾 ,通过症状、体征、X线、CT、TCD等评价疗效。结果 :114例获随访结果 ,颈性眩晕症状缓解率 96.2 % ,伴随症状及体征有效率 10 0 %。结论 :药物高频电火花疗法治疗颈性眩晕能起到改善血液循环 ,延缓退变 ,促进损伤修复、炎症吸收 ,促进新陈代谢 ,改善脑缺血缺氧状态的作用。疗效切实可靠 ,安全可行、无毒副作用     

X线钼靶、高频超声联合应用对早期乳腺癌的诊断价值

目的探讨X线钼靶、高频超声联合诊断早期乳腺癌（EBC）的价值。方法采用x线钼靶、高频超声及两者联用对144例女性乳腺肿物患者进行检查,比较三种检查方法的差异。结果X线钼靶与高频超声检查联合应用的乳腺癌阳性诊断符合率均高于单行x线钼靶检查或高频超声检查。结论X线钼靶摄片和高频超声检查各有优势,联合应用能明显提高乳腺癌诊断的阳性率。