双极肢体导联与加压单极肢体导联电压关系测试状态的剖析.DOCVIP

临床医学论文-双极肢体导联与加压单极肢体导联电压关系测试状态的剖析 【摘要】? 　　传统的心电导联理论推导出1.15倍的加压单极肢体导联等于标准导联。以心电测试状态对这两者的电压关系进行剖析分析，结果显示，标准导联与加压单极肢体导联的电压关系只能是aVF =Ⅱ-Ⅰ或（Ⅱ+Ⅲ）/2 ； aVL =Ⅰ-Ⅱ或（Ⅰ-Ⅲ）/ 2；aVR =-(Ⅰ+Ⅱ)/2 或（-Ⅰ/2）+ （-Ⅱ/2）。在由标准导联与加压单极肢体导联构成直角座标系测量心电轴时需将加压单极肢体导联×1.15并不表明标准导联的电压是加压单极肢体导联的1.15倍，仅仅只是为了使其推算公式与标准导联系统测量心电轴的推算公式达到一致而已。 【关键词】? 标准导联　加压单极肢体导联　电压　关系　 心电描记术 　　Take Apart Test Circuit on Relation to Voltage between Standard Leads　and Augmented Uniporlar Limb Leads 　　Abstract? Voltage of standard leads be 1.15 times that of augmented unipolar leads from the traditional theory on electrocardiac lead.The relation to voltage for standard leads and augmented unipolar limb leads was taked apart by condition of test cardioelectricity. It follows that the relation to voltage between standard leads and augmented unipolar limb leads is only aVF = Ⅱ - Ⅰor（Ⅱ + Ⅲ）/2 ； aVL =Ⅰ - Ⅱor（Ⅰ- Ⅲ）/ 2；aVR =-(Ⅰ + Ⅱ)/2 or（-Ⅰ/2）+ （-Ⅱ/2）. When electrical axis is measured by the right angle coordinates department from standard leads and augmented unipolar limb leads, augmented unipolar limb leads must multiply 1.15, but it dosn′t show that standarad leads is 1.15 times that of augmented unipolar limb leads, in which case it makes just its derived formula in agreement with the derived formula of standard leads system on measuring electrical axis.??? 　　Key words?? standard leads; augmented unipolar leads; voltage; relation; electrocadiography 　　双极肢体导联［1］ 又称作标准导联，1.15倍的加压单极肢体导联［2］等于标准导联，这是由传统的心电导联理论推导出的结论。但是，现代十二导联同步记录心电图机中，六个肢体导联实际上只记录了Ⅰ、Ⅱ两个导联，而Ⅲ导与三个加压单极肢体导联均由Ⅰ、Ⅱ导推导,即［3］Ⅰ+Ⅲ =Ⅱ、aVR = -1/2（Ⅰ+Ⅱ）、aVL=Ⅰ-1/2（Ⅱ）、aVF=Ⅱ-1/2（Ⅰ）。这与方程［4］aVR=-（Ⅰ+Ⅱ）/2、aVL=（Ⅰ-Ⅲ）/2、aVF =（Ⅱ+Ⅲ）/2是一种方程的两种表达方式，并没有使用传统的标准导联 = 加压单极肢体导联×1.15这个公式。笔者试图以心电测试状态对这两者的电压关系进行剖析。 　　1? 1.15倍加压单极肢体导联等于标准导联 ??? 标准导联的波幅经常是Wilson’s单极肢体导联的3（1.73）倍。Ｇoldberger’s加压单极肢体导联较Wilson’s导联大50%，如此，就可以得出3种导联的量的关系，即：标准导联 = 1.73×单极肢体导联 =1.731.5×加压单极肢体导联 = 1.15×加压单极肢体导联。 ??? 由于规定了这种标准导联与加压单极肢体导联的电压关系，所以在测量额面心电轴欲选择一个标准导联与一个加压单极肢体导联构成直角座标系时，强调必须考虑到它们间“比重”的不同而乘或除以上述的数值方较精确。 　　2? 肢体导联测试状态的剖析 ??? 李