左心室肥大心电图诊断研究进展  

Research progress of electrocardiogram diagnosis of left ventricular hypertrophy

作　　者：陈秀颖 CHEN Xiu-ying(Cardiac Function Room of Cardiology Department,Dongli Hospital of Dongli District,Tianjin 300300,China)

机构地区：[1]天津市东丽区东丽医院心内科心功能室,天津300300

出　　处：《中国城乡企业卫生》2022年第9期59-61,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：比较常规心电图(ECG)检测左心室肥大(LVH)传统标准、Cornell电压标准、∑S_(V1-V3)、∑R_(Ⅰ、Ⅱ、a VL)及两者之和(Z值)、12导联∑QRS、记分法标准、R_(V5’)、R_(V6’)标准及完全性左束支传导阻滞(CLBBB)时LVH诊断标准,显示常规ECG检测LVH的标准敏感性及准确性均高、特异性较低;Cornell电压标准诊断LVH的敏感性和准确性明显改善,特异性无差异。∑S_(V1-V3)、∑R_(Ⅰ、Ⅱ、a VL)及两者之和(Z值)诊断结果明显优于传统标准,Z值最为理想。12导联∑QRS诊断符合率为100%,比传统标准更加优异。记分法标准可应用于室内除极程序改变的病例,无需将后者作为ECG诊断LVH例外。R_(V5’)、R_(V6’)标准可以联合常规的ECG来进行诊断,可以提高LVH检出。CLBBB时LVH诊断标准具有临床价值,可作为左前分支阻滞(LAFB)合并LVH的ECG诊断标准。总之,在以上ECG诊断LVH的多个标准中,新标准涵盖面广,敏感性高,正确率高,可以对传统ECG标准进行补充。By comparing the traditional standard of routine electrocardiogram (ECG) in detecting left ventricular hypertrophy (LVH),Cornell voltage standard,∑S_(V1-V3),∑R_(Ⅰ,Ⅱ,a VL)and the sum of the two(Z value),12-lead∑QRS,scoring standard,R_(V5’),R_(V6’)criteria and the diagnostic criteria of LVH in complete left bundle branch block (CLBBB),the standard sensitivity and accuracy of routine ECG in detecting LVH are high but the specificity is low;the sensitivity and accuracy of Cornell’s voltage standard in diagnosing LVH have been significantly improved,but there is almost no difference in specificity.The diagnostic results of∑S_(V1-V3)∑R_(Ⅰ,Ⅱ,a VL )and the sum of the two (Z value)are significantly better than the traditional standard,and the Z value is the most ideal.The 12-lead∑QRS diagnosis coincidence rate is100%,which is better than the traditional standard.The scoring standard can be applied to cases whose indoor depolarization program is changed,without the latter being an exception for the diagnosis of LVH by ECG.R_(V5’)and R_(V6’)standards can be combined with routine ECG to diagnose,which can improve the detection rate of LVH.The diagnostic criteria for LVH in CLBBB have clinical value and can be used as the ECG diagnostic criteria for left anterior fascicular block(LAFB)and LVH.In conclusion,among the above multiple criteria for the diagnosis of LVH by ECG,the new standard covers a wide range of cases with high sensitivity and high accuracy,and can supplement the traditional ECG standard.

关 键 词：左心室肥大 常规心电图 诊断 

分 类 号：R587.1[医药卫生—内分泌]