心电向量图诊断高血压病左心室异常的临床应用  

Clinical Application of Vectorcardiogram in Diagnosis of Left Ventricular Abnormalities in Hypertension

作　　者：龙佑玲[1] 潘登 熊田珍 潘月 苏勇 熊霖[1] 吴彦 栗莹 LONG You-ling;PAN Deng;XIONG Tian-zhen;PAN Yue;SU Yong;XIONG Lin;WU Yan;LI Ying(Dept.of Electrophysiology,Kunming Municipal Hospital of Traditional Chinese Medicine,Kunming Yunnan 650011;Dept.of Electrocardiogram,Luohe Municipal Hospital of Traditional Chinese Medicine;Dept.of Electrocardiogram,Luohe Sixth People’s Hospital,Luohe Henan 462000;Dept.Geriatric,No.920 Hospital of PLA Joint Logistics Support Force,Kunming Yunnan 650032,China)

机构地区：[1]昆明市中医医院电生理科,云南昆明650011 [2]漯河市中医院心电图室 [3]漯河市第六人民医院心电图室,河南漯河462000 [4]解放军联勤保障部队第九二〇医院干部病房,云南昆明650023

出　　处：《昆明医科大学学报》2021年第4期113-116,共4页Journal of Kunming Medical University

基　　金：昆明市卫生科技人才培养项目心电向量技术中心基金资助项目[2020-SW(技)-0012]。

摘　　要：目的探讨心电向量图(vectorcardiogram,VCG)对高血压病早期左心室异常的诊断价值。方法对76例高血压病患者在同一次就诊或同一次住院的心电图(electrocardiogram,ECG)、心电向量图(VCG)和超声心动图(ultrasonic cardiogram,UCG)进行回顾性分析。以VCG的起始向量测量值、空间最大向量测量值与UCG的室间隔测量值、左室后壁测量值、左室舒张末期内径测量值作为左心室异常的指标,比较二者阳性检出情况;比较VCG与ECG在左心室电活动异常的检出情况。结果VCG在左心室异常的检出率为55.3%,较UCG的检出率38.2%明显增高(P<0.05);VCG在左心室电活动异常的阳性检出率为88.2%,显著高于ECG的阳性检出率71.1%(P<0.01);以VCG为标准,ECG对左室电活动异常指标的漏诊情况为:T环异常18项、左心室高电压4项、分支阻滞3项。结论VCG对高血压病早期左心室异常具有一定诊断优势,尤其可及早发现心室复极异常,与UCG联合运用可提高早期左心室异常阳性检出率。Objective To evaluate the application value of vectorcardiogram(VCG)in the diagnosis of left ventricular abnormalities in the early stage of hypertension.Methods The electrocardiogram(ECG),VCG and ultrasonic cardiogram(UCG)of 76 patients with essential hypertension at the same visit or during same hospitalization period were retrospectively analyzed.The initial vector and spatial maximum vector of VCG were used as the indicators of left ventricular abnormality,as well as the interventricular septum,left ventricular posterior wall and left ventricular end-diastolic diameter of UCG.The positive detection of the two were compared;and the detection of VCG and ECG in abnormal left ventricular electrical activity was compared.Results The detection rate of VCG in left ventricular abnormality was 55.3%,which was significantly higher than that of UCG(38.2%,P<0.05).The positive rate of VCG in abnormal left ventricular electrical activity was 88.2%,which was significantly higher than that of ECG(71.1%,P<0.01).Using VCG as the standard,ECG missed diagnosis of abnormal indicators of left ventricular electrical activity:18 T-ring abnormalities,4 left ventricular high voltage,and 3 branch block.Conclusion VCG has certain diagnostic advantages for early left ventricular abnormality in hypertension,especially for early detection of ventricular repolarization abnormality.Combined application with UCG can improve the positive detection rate of early left ventricular abnormality.

关 键 词：心电向量图 高血压病 左心室异常 早期 

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