室速积分法对预激性心动过速的价值对比研究  

A comparative Study on the value of ventricular tachycardia score in pre-excited tachycardia

作　　者：李予[1] 郭惠玲[1] 汪文娟[2] 郭继鸿[3] Li yu;Guo huiling;Wang wenjuan;Guo jihong(Peking University People's Hospital,Beijing,100044,China;Hunan Cancer Hospital,Hunan,410013,China)

机构地区：[1]湖南省肿瘤医院,410013 [2]中南大学湘雅三医院,410013 [3]北京大学人民医院,100044

出　　处：《临床心电学杂志》2019年第1期14-17,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨室速积分法与单项指标检出预激性心动过速的临床价值。方法选取30例经过电生理确诊为预激性心动过速发作时的12导联心电图,首先用室速积分法对预激性心动过速进行评分,然后选用单项诊断指标如房室分离、无人区电轴、Pava流程对预激性心动过速进行分析,比较各指标诊断预激性心动过速的临床价值。结果①室速积分法≥3分的患者0例,特异度为100%,积2分、1分、0分的特异度分别为76.6%、56.7%、66.7%,p<0.05;②房室分离、无人区电轴及Pava流程等诊断法的特异度分别为100%、100%、73.3%(p<0.05)。结论①室速积分法≥3分可完全鉴别预激性心动过速与室速(ventricular tachycardia, VT);②在单项指标中房室分离、无人区电轴特异度最高,可有效鉴别预激性心动过速与VT,Pava流程法特异度仅为73.3%,作为单项指标诊断法时不能有效鉴别预激性心动过速。Objective To investigate the clinical value of detecting pre-excited tachycardia between ventricular tachycardia(VT)score and single criteria. Methods Twelve-lead electrocardiogram(ECG) was selected from 30 patients with pre-excited tachycardia diagnosed by electrophysiology. First, VT score was used to diagnose pre-excited tachycardia, then select atrioventricular(AV) dissociation, no man’s land, pava algorithm to analyze pre-excited tachycardia, the differences of each criteria diagnosis of pre-excited tachycardia were calculated.then,single diagnostic criteria such as AV dissociation, no man’s land, pava algorithm to analyze pre-excited tachycardia,and the clinical value of each criteria in diagnosing pre-excited tachycardia was compared. Results ①0 patients with ventricular velocity integral≥3 points, the specificity was 100%. The specificity of score 2, 1 and 0 was 76.6%, 56.7%66.7%, and p<0.05, there is a significant difference. ②The specificity of criteria such as AV dissociation, no-man’s land and Pava algorithm was 100%, 100% and 73.3% respectively, and the difference was statistically significant(p<0.05). Conclusions ① Pre-excited tachycardia and VT can be completely distinguished by VT score ≥3 points.②Among the single criteria, AV dissociation and no-man’s land have the highest specificity, which can effectively distinguish pre-excited tachycardia from VT,the specificity of Pava algorithm was only 73.7%, which could not be used as a single algorithm to differentiate pre-excited tachycardia.

关 键 词：预激性心动过速 室速积分法 房室分离 无人区电轴 Pava流程法 

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