心磁图测量心脏复极时间对冠心病患者心功能预后的评估

背景：有近50%的冠心病患者在第1次发生心肌梗死前没有心脏病的征兆,因此尽早可靠地检测到冠心病、心肌缺血尤为重要.目的：采用心磁图对冠心病患者心脏复极时间变异进行测量,探讨无创的心磁图检查对冠心病患者心功能的评估作用.设计：病例-对照观察.单位：德国埃森Philippustift医院心内科.对象：选择1998-03/2002-12在德国埃森Philippustift医院心内科住院,怀疑为冠心病的患者52例,另选择10例确诊为陈旧性心肌梗死的患者作为心肌梗死组,以上患者均知情同意.对照组为32例年龄大于40岁的自愿参与观察的健康人.方法：所有患者均进行普通12导联的心电图、负荷心电图、超声心动图、冠状动脉造影检查、血生化检查及心磁图检查;对照组只行普通12导联心电图及心磁图检查,比较患者与对照组间心磁图、心电图QT离散度的变异程度.冠心病的诊断标准为冠状动脉造影检查发现冠状动脉有1支狭窄≥75%.对于心脏复极时间变异的指标,采用心磁图QT离散度及离散度均一性指数（每个心磁图探头信号与周围探头QT离散度的平均数）进行测量.主要观察指标：各组观察对象的心电图QT离散度、心磁图QT离散度及QT离散度均一性指数.结果：怀疑为冠心病的患者52例、陈旧性心肌梗死组10例及对照组32例全部进入结果分析.怀疑为冠心病的患者分为2组,冠心病组27例,无冠心病组25例.[1]心电图QT离散度的比较：各组差异无显著性意义（P＞0.05）.[2]心磁图QT离散度的比较：心肌梗死组显著高于对照组[81.3&;#177;21.5,52.4&;#177;13.6（f=13.113,P＜0.05）].[3]QT离散度均一性指数的比较：心肌梗死组与冠心病组均显著高于对照组[15.6&;#177;4.2,14.9&;#177;4.1,10.2&;#177;2.7（f=2.403,3.332,P＜0.01）].结论：心磁图能更好地反映冠心病患者心脏复极时间均一性的变异,优于普通心电图,而离散度均一性指数优于QT离散度.因为心磁图对心切线电流更为敏感,而当心肌缺血、梗死时心肌电流在心前区表现为切线电流.     

冠状动脉粥样硬化性心脏病QT离散度动态改变82例临床分析

目的研究冠状动脉粥样硬化性心脏病(冠心病)QT离散度动态改变的临床意义.方法动态测定82例冠心病组和50名健康人(对照组)的QT离散度.结果3组冠心病组QT离散度显著高于对照组(均为P＜0.01);心肌梗死组QT离散度高于一般冠心病组和心律失常猝死组(均为P＜0.01);心肌梗死组QT离散度高于心律失常组(P＜0.01).结论本文结果显示QT离散度与冠心病和心肌缺血程度有关,是临床上预测心血管事件及心律失常性猝死的可靠指标.     

冠心病的心率变异性与QT离散度的相关性研究

目的　通过对冠心病患者和冠脉造影正常者的心率变异性 (HRV)与QT离散度 (QTd)检查 ,来了解冠心病对心脏自主神经功能和心肌电稳定性的影响。方法　经选择性冠状动脉造影检查证实为心绞痛患者 12 1例 ;心肌梗死患者 5 0例 ;冠脉造影正常者 75例。于选择性冠状动脉造影术前 1天内晨 8∶30～ 10∶30用EPX采样机采样 5分钟心电图 ,经计算机处理得到HRV时域和频域分析结果 ;而QTd的测量则是在同一时间 ,同一安静检查室内同时记录标准 12导联心电图 (纸速 5 0mm/s) ,通过手工测量、计算得到QT离散度和校正的QT离散度结果。结果　心肌梗死、心绞痛患者QTd和QTcd较冠状动脉造影正常者显著延长 (P <0 .0 5 ) ;且心肌梗死患者QTd和QTcd较心绞痛者亦明显延长 (P <0 .0 5 ) ;心肌梗死的HRV指标超低频段功率谱密度 (ULFP)、极低频段功率谱密度 (VLFP)、低频段功率谱密度 (LFP)、高频段功率谱密度 (HFP)、总频谱密度 (TP)、窦性R R间期的标准差 (SDNN)较冠状动脉造影正常者及心绞痛患者显著减低 (P <0 .0 5 ) ;其中心绞痛组的HFP、LFP、SDNN亦明显低于冠状动脉造影正常者 (P<0 .0 5 ) ;3组的QT离散度与HRV均有相关关系 (P <0 .0 5 )。结论　冠心病患者的自主神经活动与心肌电稳定性受损 ,心肌梗死患者更加明显 ;冠心     

心肌梗死后抑郁患者QT间期离散度和炎症因子的变化

目的:观察心肌梗死后抑郁患者QT间期离散度的变化和炎症因子对QT间期离散度的影响。方法:选择2005-01/09在解放军第二五四医院心内科住院的急性心肌梗死患者。患者于2005-11集中来院随访,共随访到35例。根据BECK抑郁自评量表分为抑郁组(≥14分)和非抑郁组(<14分)。行12导同步心电图检查,测量QT间期离散度、校正QT间期;测定血清C反应蛋白、白细胞介素6、Ⅲ型前胶原氨基端肽含量,并分析QT间期离散度、C反应蛋白、白细胞介素6、Ⅲ型前胶原氨基端肽、BECK抑郁自评量表得分的相关关系。结果:35例患者进入结果分析。①心肌梗死后抑郁患者与非抑郁患者相比,QT间期离散度、校正QT间期显著增大[(59.4±17.6)ms,(45.6±13.1)ms;444.0ms,397.5ms,P=0.02,0.03]。②心肌梗死后抑郁患者较非抑郁患者血清C反应蛋白、Ⅲ型前胶原氨基端肽显著增高[(5.50±2.14),(4.08±1.18)mg/L;(88.83±17.62),(76.78±13.47)μg/L,P=0.043,0.049]。③QT间期离散度与C反应蛋白显著正相关(r=0.421,P=0.029),QT间期离散度、C反应蛋白与BECK抑郁自评量表得分之间未见显著相关。结论:①心肌梗死后抑郁患者复极离散程度增大,更易发生心律失常和猝死。②心肌梗死后抑郁患者有更明显的炎症反应和心室重构。③炎症反应可能通过心室重构或其他机制影响复极离散程度。     

早期康复治疗对老年急性心肌梗死患者QT间期离散度和心率变异性的影响

目的:探讨早期康复治疗对老年急性心肌梗死(AMI)患者QT间期离散度和心率变异性的影响。方法:将73例研究对象前瞻性随机分为早期康复治疗组(37例)及对照组(36例)。两组主要基线资料具有可比性。早期康复组采用早期康复治疗方案,对照组采用传统康复方案。所有研究对象分别在入院时、第1周末、第2周末、第3周末记录标准12导联心电图,测量QT间期离散度(QTd)。在发病第2周末行24h动态心电图检查和心率变异性分析。结果:①早期康复组QTd从入院时74.3±14.2ms降低到第3周末的47.3±11.4ms,与对照组比较差异有显著性意义(P<0.05)。②早期康复组HRV各项指标明显好于对照组,其中PNN50为45.0±18.91(%)高能谱为4.55±0.82ln(ms)2,与对照组比较差异有显著性意义(P<0.05)。结论:早期康复治疗对老年AMI患者可降低其QT间期离散度改善心率变异各项指标,不增加恶性心律失常的发生,降低患者猝死率。提示早期康复治疗对老年AMI患者是安全可行的。     

冠状动脉支架置入术前后冠心病患者QT离散度的变化

目的：观察冠心病患者支架置入术前后QT离散度的变化。方法：治疗组48例，均行冠状动脉造影及支架置入术，对照组28例仅行冠状动脉造影术。两组患者术前24h，术后4h、术后24h和1周分别同步记录12导联心电图，测量QT间期。结果：治疗组术后QT间期较术前明显缩短（P〈0．05）；对照组术前、术后QT间期无明显差异（P〉0．05）。结论：支架置人术后冠心病患者QT离散度降低。     

12导联体表心电图在急性冠脉综合征患者经皮冠状动脉介入术中应用与评价

目的探讨12导联体表心电图QT离散度(QTd与QTcd)变化在急性冠脉综合征(ACS)诊断治疗中的应用价值。方法选择2010年6月至2014年6月收治的经冠状动脉造影检查确诊的222例ACS患者为ACS组,92例因胸痛、胸闷症状行经冠状动脉造影检查后排除冠心病者为对照组。比较观察ACS组与对照组、ACS组不同疾病类型分组、不稳定心绞痛(UA)组不同冠状动脉狭窄评分分组以及行PCI术治疗的患者治疗前后心电图QT离散度和QTc离散度值。结果 ACS组患者QTd、QTcd值均显著高于对照组,而UA组显著高于STEMI组和NSTEMI组,NSTEMI组显著高于STEMI组,3分组显著高于1分组和2分组,2分组显著高于1分组,差异均有统计学意义(P0.05);PCI患者术后显著低于术前,差异有统计学意义(P0.05)。结论心电图的QT离散度对于ACS患者的不同病变类型、程度评估以及对PCI术前、术后的预测均具有重要价值。     

运动治疗前后急性心肌梗死患者心电图QT离散度及超声心动图相关参数的变化

目的探讨急性心肌梗死患者康复运动前后QT离散度及超声心动图参数的变化,观察QT离散度与心功能改变的关系。方法选取2001-06/2004-03汕头中心医院住院的108例急性心肌梗死患者,分成康复治疗组61例及对照组47例。康复治疗组患者于心肌梗死后4周开始康复运动,对照组不行康复治疗,所有患者于心肌梗死后4周及28周时行静态l2导联同步心电图记录及心脏超声心动图检查,进行比较。结果心肌梗死后28周时康复治疗组患者QT离散度较对照组显著缩短(P<0.01),而射血分数及左室短轴缩短率明显增加(P<0.01),E峰与A峰比值亦有所升高(P<0.05)。QT离散度与射血分数及左室短轴缩短率高度相关。结论康复治疗能缩短急性心肌梗死患者QT离散度,显著增强左室收缩功能,无创性指标QT离散度对心肌梗死患者预后的评价有一定的应用价值。     

依那普利对急性ST段抬高性心肌梗死QT间期离散度的影响

目的 探讨依那普利对急性ST段抬高性心肌梗死QT间期离散度的影响.方法 将42例冠心病急性ST段心肌梗死患者根据患者依从性分为两组,观察组26例,对照组16例,均予以心血管疾病常规治疗及护理,观察组在此基础上联合依那普利治疗,观察住院全程,随访6个月.结果 治疗后两组QT间期离散度较治疗前显著缩短(P＜0.01),观察组显著短于对照组(P＜0.05).观察组恶性心律失常发生率为7.7％,对照组为37.5％,观察组显著低于对照组(P＜o.05).结论 依那普利可明显减小急性心肌梗死后患者QT间期离散度,降低恶性心律失常发生率.     

STc延长与QT离散度对诊断心绞痛价值的探讨

目的　探讨STc延长与QT离散度诊断心绞痛的价值。方法　回顾分析 98例冠心病患者的心电图及临床资料 ,并以心脏神经官能症或肋间神经痛患者资料为对照。结果　观察组与对照组STc值分别为 (0 .12 2 8± 0 .0 0 2 2 )s和 (0 .1136± 0 .0 0 18)s,两组比较有显著性差异 ,观察组STc≥ 0 .12s者 89例 ,占90 .81% ;对照组STc≥ 0 .12s者 8例 ,占 5 %。两组STc延长发生率比较有显著性差异 ,且冠心病患者心绞痛发作时STc值与发作前后比较有显著性差异。结论　STc、QT离散度变化与心绞痛发作有内在联系 ,可精确反映心肌复极不同步性和电不稳定性 ,是诊断心绞痛的可靠指标。     

Evaluation of myocardial ischemia in Kawasaki disease using an isointegral map on magnetocardiogram

The authors have recently reported on the usefulness of the isointegral mapping technique using magnetocardiography (MCG) for the diagnosis of adult ischemic heart disease. This study evaluated myocardial ischemia in patients with Kawasaki disease (KD). The ischemia has been considered difficult to diagnose with a standard ECG. The study included 32 patients (age 3 +/- 22 years, mean 12.9 +/- 4.1 years, +/- SD) with a history of KD and 21 age-matched healthy children. Coronary arterial lesions were present in 13 patients of the KD group, MCG was carried out at rest with a multichannel superconducting quantum interference device (SQUID) system. The integral value was computed for each channel and isointegral maps were constructed during depolarization and repolarization processes. In all subjects of the control group, the integral value of repolarization was higher than that of depolarization and the isointegral map of these two processes showed similar patterns. However, the integral value of repolarization in four cases with KD (one with a history of myocardial infarction, two with a stenotic lesion in the left coronary artery, one with an aneurysmal and stenotic lesion in the right coronary artery) was lower than that of depolarization, and abnormal patterns were evident in the isointegral map. All but the case with myocardial infarction showed only mild abnormalities or almost normal on the ECG. Although sensitivity of the method for detection of myocardial ischemia was not fully assessed because of the small number of cases with significant coronary arterial stenosis, noninvasive isointegral mapping technique using the MCG could be useful for evaluation of myocardial ischemia in patients with KD.     

Magnetocardiographic QT Interval Dispersion in Postmyocardial Infarction Patients with Sustained Ventricular Tachycardia: Validation of Automated QT Measurements

T dispersion is a measure of heterogeneity in ventricular repolarization. Increased ECG QT dispersion is associated with life-threatening ventricular arrhythmias. We studied if magnetocardiographic (MCG) measures of QT dispersion can separate postmyocardial infarction patients with and without susceptibility to sustained VT. Manual dispersion measurements were compared to a newly adapted automatic QT interval analysis method. Ten patients with a history of sustained VT (VT group) and eight patients without ventricular arrhythmias (Controls) were studied after a remote myocardial infarction. Single-channel MCGs were recorded from 42 locations over the frontal chest area and the signals were averaged. QT dispersion was defined as maximum — minimum or standard deviation of measured QT intervals. VT group showed significantly more QT and JT dispersion than Controls. QT_apex dispersions were 127 ± 26 versus 83 ± 21 ms (P = 0.004) and QT_end dispersions 130 ± 37 versus 82 ± 37 ms (P = 0.013), respectively. Automatic method gave comparable values. Their relative differences were 9% for QT_apex and 27% for QT_end dispersion on average. In conclusion, increased MCG QT interval dispersion seems to be associated with a susceptibility to VT in postmyocardial infarction patients. MCG mapping with automated QT interval analysis may provide a user independent method to detect nonhomogeneity in ventricular repolarization.     

Spatial distribution of repolarization times in patients with coronary artery disease

The potential clinical value of QT dispersion (QTd), a measure of the interlead range of QT interval duration in the surface 12-lead ECG, remains ambiguous. The aim of the study was the temporal and spatial analysis of the QT interval in healthy subjects and in patients with coronary artery disease (CAD) using magnetocardiography (MCG) and surface ECG. Standard 12-lead ECG and 37-channel MCG were performed in 20 healthy subjects, 23 patients with CAD without prior myocardial infarction (MI), 31 MI patients and 11 MI patients with ventricular tachycardia (VT). QTd was increased in CAD without MI compared to normals (ECG 46.1 +/- 6.0 vs 42.8 +/- 5.0, P < 0.05; MCG 66.8 +/- 20.3 vs 49.7 +/- 10.8, P < 0.01) and in VT compared to MI (ECG 66.8 +/- 16.5 vs 51.9 +/- 16.6, P < 0.05; MCG 93.6 +/- 29.6 vs 66.8 +/- 20.8, P < 0.005). In MCG, spatial distribution of QT intervals in patient groups differed from those in healthy subjects in three ways: (1) greater dispersion, (2) greater local variability, and (3) a change in overall pattern. This was quantified on the basis of smoothness indexes (SI). Normalized SI was higher in CAD without MI compared to normals (3.8 +/- 1.1 vs 2.7 +/- 0.6, P < 0.001) and in VT compared to MI (6.4 +/- 1.6 vs 4.2 +/- 1.4, P < 0.0005). For the normal-CAD comparison a sensitivity of 74% and a specificity of 80% was obtained, for MI-VT, 100% and 77%, respectively. The results suggest that examining the spatial interlead variability in multichannel MCG may aid in the initial identification of CAD patients with unimpaired left ventricular function and the identification of post-MI patients with augmented risk for VT.     

Spatial Distribution of QT Intervals: An Alternative Approach to QT Dispersion

QT dispersion (QTd) describes the heterogeneity of ventricular repolarization on the basis of the temporal range of QT intervals as measured in the 12-lead ECG. We examined the spatial distribution of QTd using multichannel magnetocardiograms (MCGs), which noninvasivety register changes in magnetic field strength at 37 sites over the heart. As in ECG, the MCG signal in each channel may be used to measure QT interval. By calculating QT deviation from QT_min at each site, one can reconstruct the spatial distribution of QTd. Analysis of spatial QTd in ten healthy subjects and ten patients after acute myocardial infarction (MI) showed clear differences in spatial distribution. The healthy subjects generally displayed shorter QT intervals along a line corresponding to the approximate position of the septum with longer intervals in plateaus in the upper right and lower left. Spatial QTd of the post-MI patients deviated from this pattern, often displaying a sharp rise in QT duration over specific areas, which could be related to functional and morphological disturbances. The quantification of local irregularities as well as the overall pattern on the basis of a smoothness index allowed better discrimination between healthy subjects and post- MI patients than QTd. Distribution patterns of QTd which reflect local repolarization alterations may thus represent a more differentiated marker for pathology and risk.     

QT 离散度与冠心病关系的研究进展

QT离散度（QTd）对冠心病预测心肌缺血程度、范围及预后具有重要参考价值,近年来受到广泛关注。QTd[体表心电图12导联中最大QT间期（QTmax）与最小QT间期（QTmin）之间的差值]反映心室肌细胞复极过程不均一性与冠心病心肌缺血有关系。QT离散度可用于评价冠状动脉病变特点,从而指导冠心病患者血运重建,对评估介入治疗术前及术后预后具有重要的临床意义。     

Clinical and functional assessment of electric heart instability in patients with painless myocardial ischemia

Markers of electric myocardial instability were studied in 82 patients during painless episodes of coronary heart disease (CHD). Clinical examination was supplemented by 12-lead ECG, 24-hour ECG monitoring, functional tests, echocardiography, signal-averaged ECG, recording of LVP, analysis of cardiac rhythm variability, and assessment of ventricular repolarization time. It is concluded that a combination of 24-hr ECG monitoring and functional tests (veloergometer) is indispensable for diagnostics of CHD and the evaluation of the patient"s condition. Daily dynamics of myocardial ischemia and the number of its painless episodes are shown to correlate with the results of signal-averaged ECG, Q-T dispersion and LF/HF ratio. Patients with painless CHD show enhanced frequency of myocardial infarction with the Q-wave, high-grade ventricular extrasystole, and LVP coupled to disordered autonomous vegetative control of the sinus rhythm.     

急性心肌梗死48例QT离散度临床意义

目的探讨急性心肌梗死患者溶栓治疗前后QT离散度及校正的QT离散度的变化与恶性心律失常、猝死等心脏事件发生率的相关性。方法将48例急性心肌梗死患者溶栓治疗后根据其是否再通分为两组,分别观察溶栓治疗前后的QT离散度及校正的QT离散度,记录其恶性心律失常、猝死等心脏事件的发生率,并进行统计分析。结果经溶栓治疗后急性心肌梗死患者再通者29例,未通者19例。溶栓再通组于再通后24h内QT离散度迅速降至正常水平,未通组于溶栓治疗后7d方逐渐接近正常水平。溶栓治疗第3d末,再通组QT离散度及校正的QT离散度与治疗前比较差异均有极显著性(t=2.825,2.719,P均<0.01),未通组与治疗前比较均无显著性差异(P>0.05),两组间比较差异均有极显著性(t=2.713,2.941,P均<0.01)。心脏事件发生组QT离散度及校正的QT离散度均极显著高于未发生组(t=2.819,2.691,P均<0.01)。结论QT离散度与心肌梗死后局部心肌复极电活动的不均一性有关;QT离散度及校正的QT离散度越大,恶性心律失常发生率越高。     

New Insight into Repolarization Abnormalities in Patients with Congenital Long QT Syndrome: the Increased Transmural Dispersion of Repoiarization

There is evidence from experimental studies that the time interval from the peak to the end of T-wave reflects the transmural dispersion in repolarization (electrical gradient) between myocardial "layers" (epicardial, M-cells, endocardial). Since Congenital Long QT Syndrome (LQTS) is considered to be classical disease or repolarisation abnormalities, we performed the present study to assess the transmtiral dispersion of repolarization in LQTS patients. The study group consisted of 17 patients: 7 LQTS pts and 10 pts from the control group. In each patient the 24-hour ECG recording was performed on magnetic tape. The interval from the peak to the end of the T-wave (TpTo) was automatically measured by Holter system during every hour as a measure of transmural dispersion of repolarisation. Thereafter the mean TpTo from 24-hours was calculated. In addition the spatial QT dispersion was measured from 12 lead ECG and 3 channel Holter tape as a difference between the shortest and the longest QT interval between leads. The values were compared between groups using the Anova test.
TpTo was 79,6±9,6 ms (72–92 ms) in LQTS group and 62,4±7,5 ms (51–70) in the control group (p< 0.001). In LQTS group TpTo was significantly longer at night hours 72,5±2 when compared to day hours 87,4±8 (p<0.01). The spatial QT dispersion was significantly higher in LQTS patients when compared to control, both in 12-lead standard and Holter ECG.
Congenital long QT syndrome is associated with increase in both transmural and spatial dispersion of repolarization. The extent of prolongation of the terminal portion of QT in patients with congenital long QT syndrome is greater at night sleep hours compared to daily activity.     

心脏磁共振组织追踪技术评估冠心病心肌梗死的诊断价值

目的探讨心脏磁共振组织追踪技术(cardiovascular magnetic resonance tissue tracking technology,CMR-TT)与冠心病患者左心功能相关性及定量化评价心肌梗死的诊断价值。材料与方法对23例冠心病患者和16名健康志愿者进行3.0 T SSFP电影序列以及对比延迟增强扫描,用CVI42软件测量心功能,并使用组织追踪技术对左心室整体和节段的应变进行分析,得到心肌径向、周向、纵向三个方向CMR-TT 3D应变参数值。对上述参数值进行组间均值比较、组内相关系数(ICC)分析、Pearson相关性分析、Logistic回归模型、受试者工作特性(receiver operating characteristic,ROC)曲线分析。结果左心室整体径向应变(radial strain,RS)(ICC=0.944)、周向应变(circumferential strain,CS)(ICC=0.988)、纵向应变(longitudinal strain,LS)(ICC=0.987)均表现较好的可重复性。冠心病组左心室整体的径向应变、周向应变、纵向应变低于健康人组(30.35%±17.26%和45.46%±8.90%、-13.92%±5.7 7%和-1 9.3 4%±2.3 0%、-11.3 0%±4.7 5%和-1 6.5 4%±2.4 0%,P值均0.01)。左心室射血分数与径向应变呈强相关(r=0.774,P0.001),与周向应变呈强相关(r=0.778,P0.001),与纵向应变呈极强相关(r=0.802,P0.001)。冠心病组延迟强化(late gadolinium enhancement,LGE)阳性心肌节段径向应变、周向应变、纵向应变峰值低于LGE阴性心肌节段(9.95%和41.42%,-7.67%和-17.2%,-6.68%和-13.83%,P值均0.01)。心肌径向应变(AUC=0.914)、周向应变(AUC=0.911)在诊断心肌节段梗死中具有较高的诊断价值,纵向应变(AUC=0.819)具有一定的诊断价值;当心肌径向应变截断值为16.83%时,诊断准确度较高(Youden指数=0.7399);当周向应变截断值为-11.44%时,诊断准确度较高(Youden指数=0.7511);纵向应变在截断值为-9.41%时,诊断准确度较低(Youden指数=0.5552)。当使用径向应变和周向应变联合诊断冠心病心肌节段梗死时,AUC和特异度较各指标独立诊断时提高,在联合诊断时纵向应变无预测意义。结论心脏磁共振组织追踪技术在临床应用中具有较好的可行性及可重复性;径向应变、周向应变、纵向应变与冠心病左心室射血分数具有较强的相关性;径向应变、周向应变在诊断冠心病心肌节段梗死的诊断价值较高,纵向应变诊断价值有限。当使用径向应变和周向应变两项指标联合诊断时可提高诊断效能。这提示CMR-TT的应变分析在无需对比剂的情况下识别冠心病心肌梗死节段具有潜在的临床诊断价值。     

早期复极改变106例心电图特征分析

目的　探讨早期复极改变(ERV)患者的临床心电图特征.方法　根据临床及心电图表现入选ERV患者106例,并入选健康体检者100名作为对照组,分析比较两组心电图特征及ERV好发部位.结果　早期复极改变组与健康对照组平均心率分别为(68.6±8.4)、(74.8±12.6)次/min,QRS时限分别为(95±10)、(96±11)ms,Q-T离散度分别为(388±12)、(379±14)ms,Tp -Te分别为(80.4±7.6)、(78.5±8.3)ms,组间比较差异均无统计学意义(t值分别为0.72、0.58、0.65、0.59,P均＞0.05).J波在下壁导联的发生率为67.9％ (72/106),侧壁为15.1％ (16/106),中胸为17.0％ (18/106),下壁导联的发生率明显高于其他导联(x2值分别为为57.1、68.5,P均＜0.01).结论 ERV在下壁导联多见.