心电图不同电压标准对左心室肥大的诊断效能比较  

Comparison of diagnostic efficiency among different ECG voltage criteria for left ventricular hypertrophy

作　　者：唐薇 欧阳微娜 曾晨卉 范咏梅[1] TANG Wei;OUYANG Weina;ZENG Chenhui;FAN Yongmei(Department of Function,Hunan Provincial People􀆳s Hospital,Changsha Hunan 410000,China)

机构地区：[1]湖南省人民医院功能科,湖南长沙410000

出　　处：《实用心电学杂志》2022年第5期355-360,364,共7页Journal of Practical Electrocardiology

基　　金：湖南省自然科学基金资助项目(2019JJ80006)。

摘　　要：目的比较12导联常规心电图不同电压标准诊断原发性高血压相关性左心室肥大(left ventricular hypertrophy,LVH)的临床价值,探讨提高心电图诊断效能的方法。方法选取我院收治的原发性高血压患者共161例,完善超声心动图与12导联常规心电图检查并进行对比分析。根据左心室重量指数(left ventricular mass index,LVMI)将这些患者分为LVH阳性组(67例)和LVH阴性组(94例)。基于心电图数据计算Sokolow、Cornell与Peguero-Lo Presti标准以及三者联合方案的敏感性、特异性和约登指数,并在不同性别人群中进行比较。结果LVH阳性组的左心室重量及LVMI值明显高于LVH阴性组,且差异有统计学意义(P<0.01);Peguero-Lo Presti标准的敏感性高于另两个标准,但特异性更低。相较于单一标准,三者联合诊断的敏感性最高,特异性最低。无论是在男性还是女性患者中,三者联合诊断的约登指数最高,其次为Peguero-Lo Presti标准,另两个标准更低。结论采用单一标准诊断LVH时更推荐Peguero-Lo Presti标准,而三者联合诊断有助于提高LVH的心电图检出率,具有一定的临床应用价值。Objective To compare the clinical value of different voltage criteria of 12-lead routine ECG in diagnosing left ventricular hypertrophy(LVH)related to primary hypertension,and to explore a method for improving the diagnostic efficiency of ECG.Methods A total of 161 patients with primary hypertension admitted to our hospital were selected.They all underwent examinations of echocardiography and 12-lead routine ECG,and these results were comparatively analyzed.According to the left ventricular mass index(LVMI),these patients were divided into LVH positive group(67 cases)and LVH negative group(94 cases).The sensitivity,specificity and Youden index of Sokolow,Cornell and Peguero-Lo Presti criteria,and the combined regimen were calculated based on ECG data,and compared between the genders.Results The values of left ventricular mass and LVMI in the LVH positive group are significantly higher than those in the LVH negative group with statistically significant differences(P<0.01).The sensitivity of Peguero-Lo Presti criterion is higher than that of the other two criteria,but the specificity is lower.Compared with single diagnostic criterion,the sensitivity of the combined regimen is the highest while its specificity is the lowest.Either in male or female patients,the Youden index of the combined regi-men is the highest,followed by the index of Peguero-Lo Presti criterion,and the other two criteria.Conclusion Peguero-Lo Presti criterion is more recommended in diagnosing LVH with single diagnostic criterion.The combined regimen of the three criteria helps to increase the detection rate of LVH by ECG,which provides certain clinical ap-plication value.

关 键 词：心电图 左心室肥大 Peguero-Lo Presti电压标准 原发性高血压 

分 类 号：R541[医药卫生—心血管疾病] R544.11[医药卫生—内科学]