心向量图QRS环评价左室收缩同步性  

Evaluation of left ventricular systolic synchrony by QRS complex in Three-Dimensional Cardiogram

作　　者：李强 徐兆龙 刘仁光 Li qiang;Xu zhaolong;Liu renguang(Cardiology department,1st Affiliated Hospital of Liao Ning Medical College, Liaoning,Jinzhou,121000,China)

机构地区：[1]锦州医科大学附属第一医院,121000

出　　处：《临床心电学杂志》2018年第3期179-183,共5页Journal of Clinical Electrocardiology

基　　金：辽宁省科技项目(项目编号:2012225019)

摘　　要：目的探求立体心电向量图QRS环相关指标对左室收缩同步性评价的灵敏度和特异度。方法入选确诊为左室射血分数降低的心衰患者103例,分别应用心脏彩超、心电图及立体心电向量图相关指标对患者左室收缩同步与否进行评估,并计算各指标灵敏度及特异度,各指标间差异行配对检验。结果 (1)QRS环最大向量夹角(χ~2=5.1429,p<0.05)、QRS环最大向量发生时间(χ~2=7.1111,p<0.01)灵敏度高于QRS时限灵敏度,有统计学意义。(2)QRS环最大向量振幅(χ~2=7.2000,p<0.01)、QRS环是否出现"8字型"扭曲、双重扭曲(χ~2=8.0700,p<0.01)特异度均低于QRS时限特异度,有统计学意义。(3)QRS环运行时限特异度(χ~2=4.000,p<0.05)高于QRS时限特异度,有统计学意义。结论评价左室收缩同步性的立体心电向量指标中QRS环最大向量夹角、QRS环最大向量发生时间具有较高灵敏度,而QRS环运行时间特异度更高。Objective To explore the sensitivity and specificity of QRS complex in three-dimensional cardiogram in evaluating left ventricular systolic synchrony.Method Select hospitalized patients (103 cases)who underwent heart failure to take Eehocardiography,ECG,VCG and 3D-VCG,then evaluating LV dyssynchrony by indicators of checks above respectively .Lastly,calculating the sensitivity and specificity of every indicators and comparing the difference of every indicators by Matching test.Results (1)The sensitivity of the largest vector angle of QRS loop (X^2=5.1429,p<0.05)and the largest vector duration of QRS loop (X^2=7.1111,p<0.01)are higher than QRS duration,and the difference is significant.(2)The specific of the largest vector amplitude of QRS loop (X^2=7.2000,p<0.01),"8 word form",distorted and double-distorted changes(X^2=8.0700,p<0.05)are lower than QRS duration and the difference is significant.(3)The specific of QRS loop duration (X^2=4.0000,p<0.05)is higher than QRS duration,and the difference is significant.Conclusion The indicators of QRS complex in Three-Dimensional Cardiogram can be used to evaluate left ventricular systolic synchrony.

关 键 词：慢性心力衰竭 立体心电向量图 心电图 心脏彩超 

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