立体心电向量图对左心室肥厚的诊断价值  

Evaluation of 3-dimension vectrocardiography for diagnosis of left ventricular hypertrophy

作　　者：崔超英[1] 柯元南[1] 王云[1] 

机构地区：[1]中日友好医院,100029

出　　处：《临床心电学杂志》2009年第5期351-353,共3页Journal of Clinical Electrocardiology

摘　　要：目的以二维超声心动图(UCG)作为诊断依据,与常规心电图(ECG)比较,评价立体心电向量图对左心室肥厚(LVH)的诊断价值。方法以二维超声心动图作为左心室肥厚的诊断标准,并测算出左心室重量指数(LVMI)。以男性左心室重量指数(LVMI)≥97g/m2、女性左心室重量指数(LVMI)≥86g/m2为标准,分为左心室肥厚组及正常对照组;两组同时行心电图和立体心电向量图检查,常规心电图左心室肥厚的诊断标准采用修改的纽约心脏病学会(NYHAC)标准,分别计算立体心电向量图和常规心电图诊断左心室肥厚的敏感性、特异性、阳性正确率、阴性正确率、诊断准确率。两组间的比较用x2检验。结果LVH组3D-VCG的典型表现是额面(F)QRS环最大向量振幅和水平面(F)QRS环最大向量振幅明显增大,且QRS环空间最大向量偏向左后。立体心电向量图诊断左心室肥厚的特异性和阳性正确率与心电图无显著差异(p>0.05);但敏感性显著高于心电图(p=0.0001),阴性正确率、诊断准确率亦均显著高于心电图(p=0.005)。结论由于立体心电向量图较常规心电图能获得更全面的信息,在左心室肥厚诊断方面,立体心电向量图的诊断价值高于常规心电图。Objective Regarding ultrasonic cardiography as diagnosis criteria and contrasted with regular ECG,to evaluate the criteria for 3-Dimension vectrocardiography （3D-VCG） diagnosis of left ventricular hypertrophy（LVH）. Methods The left ventricular mass index （LVMI） is measured by ultrasonic cardiography （UCG）. The patients were divided into the LVH group and the control group according to LVMI. The LVMI in the LVH group is more than 97g/m^2 for the male or 86g/m^2 for the female,while the one in the control group is less than that. 3D-VCG of two groups was analyzed by correlating with regular electrocardiography （ECG）. 3D-VCG and regular ECG were compared with in sensitivity,specificity,positive accuracy,negative accuracy and diagnosis accuracy. Results There was significant difference between the two methods in sensitivity （p=0.0001）,negative accuracy （p=0.005） and diagnosis accuracy （p=0.005）,while there was no significant difference in specificity （p〉0.05）. And in positive accuracy （p〉0.05）,3D-VCG significantly prefers to regular ECG. Conclusion As 3D-VCG can get more detailed information than regular ECG,3D-VCG is available to detect LVH,which is more accurate than regular ECG.

关 键 词：心电向量图 立体心电向量图 超声心动图 

分 类 号：R540.41[医药卫生—心血管疾病] R541.7[医药卫生—内科学]