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目的研究70岁以上健康老年人右胸及后壁导联心电图特点。方法对212例70岁以上健康老年人右胸及后壁导联的P波、QRS波及ST段进行形态观察及测量分析。结果(1)右胸导联rS波形检出率为31.1%～58.1%;QS波形检出率为14.0%～23.3%;V4R导联(QS波除外)、V5R导联各波振幅低于V3R导联(P<0.05);(2)后壁V7～V9导联qR波形检出率为50.0%～87.7%;R波形检出率为7.1%～34.9%;与V7导联比较,V8、V9导联qR波形的出现率递增,R波形出现率及R波振幅均呈现递减(P<0.05);(3)ST段:V3R～V5R导联97.5%～98.9%位于等电位线;V7～V9导联97.2%～98.5%位于等电位线;极少数抬高者幅度<0.05mV,无ST段下降;(4)T波:V3R～V5R导联61.3%～79.2%为平坦,21.8%～25.8%为倒置;V7～V9导联45.1%～78.5%为平坦,20.0%～53.7%为直立。结论建立70岁以上老年人右胸及后壁导联心电图的诊断标准具有实际的临床意义。
Objective To study the electrocardiographic features of right chest and posterior wall leads in healthy elderly over 70 years old. Methods Morphological observation and measurement of P-wave, QRS-wave and ST-segment of 212 right elbow and posterior wall leads of 212 elderly people over 70 years of age were performed. Results (1) The detection rate of rS waveforms in right chest lead was 31.1% -58.1%, the detection rate of QS waveforms was 14.0% -23.3%, the amplitude of each wave in V4R lead (except QS wave) was lower than that of V3R (P <0.05). (2) The detection rate of qR waveform in V7 ~ V9 leads was 50.0% ~ 87.7% and the detection rate of R waveform was 7.1% ~ 34.9%. Compared with V7 lead, V8, (3) ST segment: 97.5% ~ 98.9% of V3R ~ V5R leads are located on the equipotential line; V7 ~ (4) T wave: 61.3% ~ 79.2% of V3R ~ V5R leads are flat, 21.8% ~ 25.8% were inverted; V7 ~ V9 leads 45.1% ~ 78.5% is flat, 20.0% ~ 53.7% is upright. Conclusion The establishment of electrocardiogram diagnostic criteria of the right chest and posterior wall leads in elderly patients over 70 years has practical clinical significance.