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[摘要] 目的 探討心电散点图在房颤伴室性早搏与房颤伴室内差异性传导鉴别诊断中的应用价值。 方法 选择2018年2月～2019年2月本院心内科50例房颤伴室性早搏患者为实验组，同时选取50例房颤伴室内差异性传导患者为对照组，均接受心电散点图检查，对两组心电散点图的特征进行分析。 结果 所有患者的散点图均存在基础图形，患者的心室率越快，其扇形与近端越靠近，患者的心室率越慢，则其与远端越靠近;对照组患者的心电散点图为单一扇形。患者的室内差异性传导心搏，均处于扇形内，若其较多室内差异性传导心搏的相关联律间期一致，则会有红色带形成，仍然处于扇形内;实验组患者的心电散点图主要存在3种散点分布形态，其中58%患者心电散点图的扇形外，存在沿坐标轴平行分布的相关红色带;30%患者心电散点图扇形内，存在垂直分布的带状;12%患者心电散点图的相关散点，不存在明显的特征改变。 结论 房颤伴室内差异性传导患者，其散点图中相关散点主要在扇形内集中。房颤伴室性早搏患者，其不同联律间期的扇形散点内存在不同的分布图形。

[关键词] 心电散点图;房颤;室性早搏;室内差异性传导

[中图分类号] R541.7          [文献标识码] A          [文章编号] 1673-9701（2020）17-0005-03

The role of ECG scattergram in the differential diagnosis of atrial fibrillation with ventricular premature beats and atrial fibrillation with intraventricular differential conduction

XIANG Qun

Department of Electrophysiology， Yueyang Hospital of Traditional Chinese Medicine in Hu'nan Province， Yueyang 414000， China

[Abstract] Objective To explore the value of ECG scattergram in the differential diagnosis of atrial fibrillation with ventricular premature beats and atrial fibrillation with intraventricular differential conduction. Methods 50 patients with atrial fibrillation and ventricular premature beats in our department of cardiology from February 2018 to February 2019 were selected as the experimental group， and 50 patients with atrial fibrillation and intraventricular differential conduction were selected as the control group. All patients underwent ECG scattergram examination. The characteristics of ECG scattergram between two groups were analyzed. Results The scattergrams of all patients had basic graphics. The faster the patient's ventricular rate， the closer the fan shape was to the proximal end. The slower the patient's ventricular rate， the closer it was to the distal end. The ECG scattergram of the patients in the control group was a single fan. The patient's intraventricular differential conduction heartbeats were all in a fan shape. If there were more consistent coupling intervals associated with intraventricular differential conduction heartbeat， a red band was formed and was in the fan shape. There are three main types of scatter distribution in the ECG scattergram of the experimental group. 58% of the patients had related red bands that are parallel to the coordinate axis besides ECG scattergram outside of the fan shape. 30% of the patients had vertical distributed bands inside the ECG scattergram. 12% of patients had no obvious characteristic change about the relevant scatter plots of ECG scattergrams. Conclusion In patients with atrial fibrillation and intraventricular differential conduction， the scattered points in the scattergram are mainly concentrated in the fan shape. In patients with atrial fibrillation and ventricular premature beats， there are different distribution patterns in the fan-shaped scattered points of different coupling intervals.

[Key words] ECG scattergram; Atrial fibrillation;Ventricular premature beats; Intraventricular differential conduction

心电散点图是一种非线性分析方法，对应患者不同的心率、心律，其几何特征存在一定的差异性[1]。心电散点图是对心律失常分析的新型方法，其具有快捷、方便的特点[2]。心房颤动即房颤，房颤是临床常见的疾病，属于心律失常的一种，患者可伴室性早搏、室内差异性传导等情况。……