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临床资料患者女,55岁。高血压冠心病5年。近年米进行性乏力、发作性心前区疼痛伴晕厥2次,于1984年2月25日入院。检查:血压150/100,神志清楚。无紫绀。颈静脉不怒张。心率平均70次/分,不齐。无器质性杂音。肺无罗音。下肢无浮肿。神经系检查无异常。1983年9月5日心电图(见插页附图上条)示窦性心律,频率88次/分,规则。P-R 间期0.28秒。QRS波属室上型,V_1 导联呈rSr′,V_5 呈qRS 型,各导联QRS波终末部增宽,为不完全性右束支传导阻滞。1984年2月25日心电图(见插页附图下三条)示窦性P 波顺序出现,100次/分,规则。P 波与QRS 波无平均关系,房牢>室率。QRS 波宽达0.14秒。畸形。固定70次/分。R-R 间期呈长-短-更短-长或长-短-长的规律性变化。V_1 导联呈rsR′,V_5 呈qRS 型。各导联QRS 波终末部尖锐,酷似逆行P 波。T 波与QRS 波终末部方向相反。
Female patient, 55 years old. Hypertensive coronary heart disease for 5 years. In recent years, progressive malaise, paroxysmal prefrontal pain with syncope 2 times, in February 25, 1984 admission. Check: blood pressure 150/100, conscious. No cyanosis. Jugular vein does not rage. Average heart rate 70 beats / min, missing. No organic noise. Lung non-rales. Lower extremity without edema. Nervous examination no abnormalities. September 5, 1983 electrocardiogram (see inset drawings on the article) showed sinus rhythm, the frequency of 88 beats / min, the rules. P-R interval 0.28 seconds. QRS is supratentorial type, V_1 lead was rSr ’, V_5 was qRS type, the leading end of each lead QRS wave widening, incomplete right bundle branch block. February 25, 1984 ECG (see insert the next three under the map) showed sinus P wave order, 100 beats / min, rules. P wave and QRS wave without an average relationship, room> room rate. QRS wave width of 0.14 seconds. deformity. Fixed 70 beats / min. R-R interval was long - short - shorter - long or long - short - long regular changes. V_1 lead was rsR ’, V_5 was qRS type. Each lead QRS end of the sharp wave, exactly like the retrograde P wave. T wave and QRS wave terminal opposite direction.