Selvester QRS心电图评分对肥厚型心肌病的诊断价值研究  

Research on the Diagnostic Value of Selvester QRS Electrocardiogram Score in Hypertrophic Cardiomyopathy

作　　者：郭健[1] 陈远忠[1] GUO Jian;CHEN Yuanzhong(Panzhihua Central Hospital,Panzhihua 617067,Sichuan,China)

机构地区：[1]攀枝花市中心医院

出　　处：《中西医结合心脑血管病杂志》2019年第24期4039-4042,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨Selvester QRS心电图评分在肥厚型心肌病(HCM)心肌纤维化诊断中的应用价值。方法选取2016年1月-2018年4月在攀枝花市中心医院治疗的HCM病人82例,均行标准12导联心电图检查并计算Selvester QRS评分,同时行钆对比剂延迟强化(LGE)对心肌纤维化进行评价。结果82例病人中,LGE阳性55例;LGE阳性病人最大室壁厚度和左室质量指数(LVMI)分别为(24.53±3.82)mm和(97.78±20.01)g/m 2,明显高于LGE阴性病人的(19.91±2.81)mm和(74.10±18.82)g/m^2,差异均有统计学意义(P<0.05);LGE阳性病人左室射血分数(LVEF)为(69.89±9.10)%,明显低于LGE阴性病人的(76.24±8.18)%,差异有统计学意义(P<0.05);LGE阳性病人Selvester QRS评分和左心室心肌瘢痕面积百分比(%LV Scar)分别为(5.80±2.11)分和(17.42±3.61)%,明显高于LGE阴性病人的(1.70±0.72)分和(5.12±2.03)%,差异均有统计学意义(P<0.05);Selvester QRS评分与LGE总分呈正相关(r=0.931,P<0.05),%LV Scar与LGE%呈正相关(r=0.932,P<0.05);Selvester QRS评分判断病人LGE阳性的ROC曲线下面积为0.810,P<0.05,截断值为3.30分时,灵敏度为92.70%,特异度为70.40%。结论Selvester QRS心电图评分在肥厚型心肌病心肌纤维化诊断中有一定的应用价值。Objective To investigate the value of Selvester QRS electrocardiogram(ECG)score in the diagnosis of myocardial fibrosis in hypertrophic cardiomyopathy(HCM).Methods Eighty-two patients with HCM in our hospital from January 2016 to April 2018 were selected.The standard 12-lead ECG was performed,and the Selvester QRS score was calculated.At the same time,late gadolinium enhancement(LGE)was performed to evaluate myocardial fibrosis.Results Of the 82 cases,55 cases were LGE positive patients.The maximum wall thickness and left ventricular mass index(LVMI)of LGE-positive patients were(24.53±3.82)mm and(97.78±20.01)g/m^2 respecfively,which were significantly higher than those of LGE-negative patients(19.91±2.81)mm and(74.10±18.82)g/m 2,respectively the differences were statistically significant(P<0.05).The left ventricular ejection fraction(LVEF)of LGE-positive patients was(69.89±9.10)%,which was significantly lower than that of LGE-negative patients(76.24±8.18)%,the difference was statistically significant(P<0.05).The Selvester QRS score and the percentage of left ventricular myocardial scar area(%LV Scar)in LGE-positive patients were(5.80±2.11)and(17.42±3.61)%respecfively,which were significantly higher than those of LGE-negative patients(1.70±0.72)and(5.12±2.03)%respecfively,the differences were statistically significant(P<0.05).Selvester QRS score was positively correlated with total score of LGE(r=0.931,P<0.05);%LV Scar was positively correlated with LGE%(r=0.932,P<0.05).Based on the Selvester QRS score,the area under the curve(AUC)of receiver operating characteristic(ROC)in patients with LGE positive was 0.810,P<0.05,and the cutoff was 3.30,the sensitivity was 92.70%,and the specificity was 70.40%.Conclusion Selvester QRS ECG score has certain application value in the diagnosis of myocardial fibrosis in HCM.

关 键 词：肥厚型心肌病 心肌纤维化 Selvester QRS心电图评分 钆对比剂延迟强化 左室质量指数 左心室心肌瘢痕面积百分比 

分 类 号：R542.2[医药卫生—心血管疾病] R256.2[医药卫生—内科学]