心电图QRS电压标准诊断左室肥大价值的研究  

THE STUDY OF VALUE ON ELECTROCARDIOGRAPHIC QRS VOLTAGE CRITERIA IN DIAGNOSIS OF LEFT VENTRICULAR HYPERTROPHY

作　　者：吴湘杰[1] 谢芳元[1] 

机构地区：[1]西安市第四医院,710004

出　　处：《现代电生理学杂志》2008年第2期84-87,共4页Journal of Modern Electrophysiology

摘　　要：目的:评价临床上常用的几项心电图QRS电压标准诊断左心室肥大(LVH)的价值及性别差异。方法:选择2003～2007年我院体检及住院患者496例,依据超声心动图测定的左室重量指数(LVMl)分为正常组(男207例,女83例)和左心室肥大组(男126,女80例)。计算各项QRS电压标准诊断左心室肥大的敏感性、特异性和准确率,并比较各项电压标准诊断左心室肥大的性别差异。结果:各项QRS电压标准诊断左心室肥大的特异性均>95%。在单项指标中,Rv5>2.5mV标准的敏感性和准确率分别为62.8%和85.1%,明显高于Rv6及RavL电压标准。在复合指标中,Cornell指数和Sokolow指数诊断左心室肥大的敏感性和准确率明显高于R1+SⅢ指标。男、女性采用相同的电压阈值,其诊断性能存在明显性别差异。结论:Cornell指数、Sokolow指数及Rv5电压标准是诊断左心室肥大的较好的指标。男、女性采用不同的电压阈值标准,可望进一步改善目前心电图诊断左室肥大的性能。Objective： To evaluate the value of the electrocardiographic QRS voltage criteria in diagnosis of left ventricular hypertrophy （LVH） . Methods： 496 patients were divided into control group （207 male and 83 female） and LVH group （ 126 male and 80 female） according to the LVMI determined by echocardiogram. The specificity, sensitivity and accuracy of electrocardiographic QRS voltage criteria were calculated, and the sex differences were compared in diagnosis of LVH. Results： The specificity of 〉95% for diagnosis of LVH was observed for all QRS voltage criteria. The sensitivity and accuracy of Cotnell index, Sokolow index and Rv5 〉 2.5mV criteria were markedly higher than other voltage criteria. Marked sex differences in sensitivity and accuracy were existed when applying the same voltage threshold criteria for both sexes. Conclusion： Cornell index, Sokolow index and Rv5 〉2.5mV voltage threshold are better ECG criteria for LVH detection. The use of sex - specitic voltage criteria may further improve the ECG performance for diagnosis of LVH.

关 键 词：心电图 QRS电压标准 左心室肥大 

分 类 号：R540.41[医药卫生—心血管疾病] R542.22[医药卫生—内科学]