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目的:对儿童早复极波心电图的危险分层指标进行初步分析,提高对儿童早复极波心血管预后的认识。方法:收集早复极波儿童128例,分析早复极波分布导联、J波形态、J波振幅、J波后ST段形态、J波时限、J波与R波振幅的比值(J/R比值)、Ⅱ、V5导联的T波与R波振幅的比值(T/R比值)等心电图危险分层指标,并按性别分组,进行比较分析。结果:早复极波儿童男70例,女58例;年龄3个月~14岁6个月,平均(5.3±3.5)岁。早复极波分布于下壁导联47例(36.7%),侧壁导联51例(39.8%),广泛分布者30例(23.4%)。J波振幅<0.2mV 104例(81.2%),≥0.2mV 24例(18.8%)。J波为顿挫型76例(59.4%),切迹型52例(40.6%)。J波后ST段呈上斜型102例(79.7%),水平或下斜型26例(20.3%)。J/R比值(14.7±11.3)%。Ⅱ、V5导联的T/R比值为(34.5±15.3)%。J波时限>60ms 2例。以上指标按性别分组进行比较,均无显著性差异。结论:儿童早复极波下壁导联及侧壁导联分布率相近,广泛分布者少见。J波振幅多<0.2mV,多为顿挫型,J波后ST段多呈上升型,J波时限绝大多数<60ms。男女早复极波特征相似。儿童早复极波多为良性心电图变异,但其远期心血管预后尚不明确。
OBJECTIVE: To analyze the risk stratification index of early repolarization wave electrocardiogram (ECG) in children, and to improve the understanding of children’s early repolarization wave cardiovascular prognosis. Methods: A total of 128 children with early repolarization wave were collected. The early repolarization wave lead, J wave morphology, J wave amplitude, J wave ST segment morphology, J wave duration, J wave amplitude and R wave amplitude (J / R ratio), the ratio of T wave and R wave amplitude (T / R ratio) between leads II and V5, and the ECG risk stratification indexes were grouped by sex and analyzed comparatively. Results: There were 70 males and 58 females with early repolarization wave. The average age was (5.3 ± 3.5) years old, ranging from 3 months to 14 years and 6 months. Early repolarization wave was found in 47 cases (36.7%) of the inferior leads, 51 (39.8%) in the lateral leads, and 30 cases (23.4%) were widely distributed. J wave amplitude <0.2mV in 104 cases (81.2%), ≥ 0.2mV in 24 cases (18.8%). 76 cases (59.4%) were J-wave type and 52 cases (40.6%) were notch type. There were 102 cases (79.7%) of oblique ST segment and 26 cases (20.3%) of horizontal or oblique type in ST wave after J wave. J / R ratio (14.7 ± 11.3)%. Ⅱ, V5 lead T / R ratio of (34.5 ± 15.3)%. J wave time limit> 60ms 2 cases. The above indicators by gender groups were compared, no significant difference. Conclusion: The distribution of leads and sidewall leads in children with early repolarization wave is similar, with a wide distribution. J-wave amplitude of more than 0.2mV, mostly frustrated type, J-wave ST-segment were mostly ascending type, J wave most of the time limit <60ms. Early complex waves of men and women have similar characteristics. Early complex wave of children are mostly benign ECG changes, but its long-term cardiovascular prognosis is not yet clear.