【摘要】 目的 找出正常成人最大QT间期(QTmax)和最小QT间期(QTmin)在十二导心电图的分布规律，提高QT离散度的敏感性。方法 对582例正常成人进行十二导心电图同步记录检查，找出QTmax和QTmin在各导联的数量和在十二导心电图中的分布规律，统计各导联缺失和不同导联组合缺失时的QT离散度均值，观察其对QTd的影响。结果 582例心电图平均QTd 35.3±9.5 ms，各导联QT间期均值avL最小，V2、V3导联最大。aVL导联中92%为QTmin，无一例为QTmax,V2、V3两个导联中QTmax占97%，QTmin大部分分布在Ⅰ、aVL、V1导联，以单一或同时在两个导联中存在为主，40%单一存在aVL导联中。QTmax大多分布在V2～5的胸导联中，同时在三个或三个以上导联中存在为主。缺乏相应导联时对QTd的影响由大到小为：Ⅰ、aVL、V1→avL、V1→V2、V3、V4→Ⅰ、aVL→V2、V3→aVL→Ⅰ、V1。Ⅱ、Ⅲ、avF和V4～6导联缺失时，对QTd的影响不大(P＞0.05)。结论 如果十二导心电图中只有aVL或Ⅰ、aVL导联为QTmax或V2、V3导联都为QTmin，即使QTd只有20～30 ms也可以视为异常。不同导联及其组合的缺失，对QTd的影响不同。测量QTd时以不能少于八个或八个以上导联作为条件并不够，应加上不要缺乏aVL导联，Ⅰ、V1和V2、V3导联不能同时缺乏为条件。QTd还与心脏各部位的血流供应有关，测QTd时如按心电图的定位的某部位的各导联全部缺失，也影响QTd的敏感性。Distribution and clinical significance of normal adult s
QTmax and QTmin in 12-lead electrocardiogram
Wu Pingbin，Hu Yimin，Cai Wenyang
（Chaozhou Central Hospital, Chaozhou 521000）
【Abstract】 Objective By studying the distribution of adult s QTmax and QTmin in ECG 12-lead to increase the sensitivity of QT dispersion. Method 582 normal adults undergone ECG examination were studied respectively. QTmax and QTmin were calculated in each lead, and the mean of QT dispersion (QTd) was also calculated in the absence of different lead or lead combinations.Results The mean of QTd was 35.3±9.5 ms. The mean of QT interval was minimal in aVL and maximal in V2 and V3. 92% of QT intervals were QTmin without QTmax in aVL, and 97% were QTmax in V2 and V3. Most QTmin distributed in Ⅰ, aVL and V1， and mainly existed in single or double leads, and 40% of them existed in aVL. Most QTmax distributed in V2 to V5, existed in at least three leads. When the matched lead was absent, QTd was affected from maximal to minimal: Ⅰ, aVL, V1→aVL, V1→V2，V3，V4→Ⅰ, avL→V2, V3→aVL→Ⅰ,V1. When Ⅱ, Ⅲ, aVF and V4 to V6 were absent, QTd was not affected (P＞0.05).Conclusion If QT intervals are QTmax only in aVL or Ⅰ and aVL, or QTmin both
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