Hoffmayer心电图积分法鉴别右室特发性与ARVC的室早或室速  

Differential Diagnosis of Idiopathic Right Ventricular PVC or VT with Arrhythmogenic Right Ventricular Cardiomyopathy Concomitant PVC or VT by Hoffmayer ECG Integral

作　　者：侯艳杰 许宏伟 罗东雷 刘蕾 陈汉杰 李露 张佳宁 何磊 HOU Yanjiei;XU Hongwei;LUO Donglei(Chengde Central Hospital/The Second Clinical College of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]河北省承德市中心医院/承德医学院第二临床学院,河北承德067000

出　　处：《河北医学》2022年第8期1321-1325,共5页Hebei Medicine

基　　金：河北省承德市科学技术研究与发展计划,(编号:201704B003)。

摘　　要：目的:探讨Hoffmayer心电图积分法早期鉴别起源于右室流出道的室早或室速属于特发性还是致心律失常性右心室心肌病(ARVC)所伴发。方法:收集2017年11月至2020年12月就诊于承德市中心医院40例患者。其中30例室性早搏或者室性心动过速是特发性右室流出道,10例室性早搏或者室性心动过速是ARVC伴发,心电图两位医师按照Hoffmayer心电图积分方法,把40例患者的心电图分析,心电图是窦性心律伴有室性早搏或室性心动过速。先用总积分方法分析上述40例患者的Hoffmayer心电图积分,再用单项积分方法分析上述40例患者的Hoffmayer心电图积分,然后跟临床诊断进行对比,最后计算该分析方法诊断的阴性预测值、阳性预测值、特异性、敏感性。结果:ARVC伴发室早或室速组与特发性室早或室速组的Hoffmayer总积分≥5分、室早或室速的窦性心律胸导联TV1~V3倒置(3分)的比例差异均有统计学意义;特发性和ARVC用Hoffmayer心电图积分≥5分,分别为30例和10例,正确诊断右室特发性室性早搏或室性心动过速和ARVC患者伴有室性早搏或室性心动过速敏感性为80.0%,特异性为90.3%,阳性预测值为80.0%,阴性预测值为81.3%;窦性心律胸导联Tv1~v3倒置的单项标准诊断ARVC患者伴发室早或室速的阴性预测值、敏感性、阳性预测值和特异性分别为93.1%,80.0%,72.7%和90.0%,两组差异有统计学意义。结论:Hoffmayer心电图积分方法≥5可有效鉴别ARVC患者伴有右室流出道室性早搏或室性心动过速还是特发性右室流出道室性早搏或室性心动过速。该方法特异性高、敏感性高、快速、简单,临床应用价值较高。Objective:To explore the clinical significance of the Hoffmayer ECG integral method in differential idiopathic right ventricular premature beat(PVC)or ventricular tachycardia(VT)with arrhythmogenic right ventricular cardiomyopathy(ARVC)PVC or VT in early stage.Method:40 cases of heart disease patients admitted to Chengde Central Hospital from Nov.2017 to Dec.2020 were collected.Among the patients,30 cases had right ventricular outflow tract PVC or VT,and 10 cases had ARVC sinus rhythm concomitant PVC or VT.The electrocardiogram of 40 patients in sinus rhythm with premature ventricular beats or ventricular tachycardia was analyzed by two ECG physicians according to the Hoffmayer ECG score method.The Hoffmeyer ECG scores of the 40 patients were analyzed using the total score method,then the Hoffmayer ECG scores of the 40 patients were analyzed using the individual score method,then compared to the clinical diagnosis,and finally,the negative predictive value,positive predictive value,specificity and sensitivity of the diagnosis were calculated for this analysis.Result:Statistically significant differences were found between the ARVC with premature or ventricular tachycardia group and the idiopathic premature or ventricular tachycardia group in terms of the proportion of total Hoffmayer points≥5 and inversion of TV1-V3(3 points)in the sinus rhythm chest leads with premature or ventricular tachycardia.The correct diagnosis of right ventricular idiopathic ventricular premature beats or ventricular tachycardia and ARVC patients with ventricular premature beats or ventricular tachycardia was 80.0%in sensitivity and 90.3%in specificity with a positive predictive value of 80.0%and a negative predictive value of 81.3%in 30 and 10 patients,respectively,using a Hoffmayer ECG score of≥5.The negative predictive value,sensitivity,positive predictive value,and specificity of the single criterion of Tv1-v3 inversion in the thoracic leads of sinus rhythm for the diagnosis of ARVC patients with ventricular premature or ventricul

关 键 词：Hoffmayer心电图积分方法 致心律失常性右心室心肌病 特发性室性早搏 室性心动过速 右室流出道 

分 类 号：R541.7[医药卫生—心血管疾病]