心电图最深S波与Sv4诊断高血压伴左心室肥厚的价值分析  

Analysis on the Value of Deepest S Wave and Sv4 in ECG in the Diagnosis of Hypertension with Left Ventricular Hypertrophy

作　　者：靳雨 文雯 韩凌 JIN Yu;WEN Wen;HAN Ling(Department of Cardiopulmonary Function,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Cardiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院心肺功能科,河南郑州450000 [2]郑州大学附属郑州中心医院心内科,河南郑州450000

出　　处：《临床医学工程》2025年第4期345-348,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20210776)。

摘　　要：目的探讨心电图最深S波(SD)与Sv4诊断高血压伴左心室肥厚(LVH)的价值。方法选取2022年8月至2024年7月本院收治的100例高血压患者为对象,根据是否合并LVH分为正常组(n=72)和LVH组(n=28)。入组患者均接受超声心动图及ECG检查,分析SD与Sv4诊断高血压伴LVH的价值。结果正常组LVDd、IVST、PWT、LVMI低于LVH组,LVEF高于LVH组(P<0.05)。正常组SD、SD+Sv4、Ravl+Sv3、Svl+Rv5均低于LVH组(P<0.05)。当SD为1.53 mv时,其诊断高血压伴LVH的AUC、灵敏度、特异度分别为0.871(95%CI:0.789~0.930)、81.43%、95.83%;当SD+Sv4为1.97 mv时,其诊断高血压伴LVH的AUC、灵敏度、特异度分别为0.915(95%CI:0.842~0.961)、89.29%、84.72%;当Ravl+Sv3为1.73 mv时,其诊断高血压伴LVH的AUC、灵敏度、特异度分别为0.829(95%CI:0.741~0.897)、58.33%、96.43%;当Svl+Rv5为2.64 mv时,其诊断高血压伴LVH的AUC、灵敏度、特异度分别为0.828(95%CI:0.740~0.899)、78.57%、79.17%。SD、SD+Sv4、Ravl+Sv3、Svl+Rv5诊断高血压伴LVH的AUC比较,差异无显著性(P>0.05),但SD+Sv4的灵敏度高于SD、Ravl+Sv3、Svl+Rv5。结论ECG作为安全简单的检查方式用于高血压伴LVH的诊断价值较高,SD+Sv4适用于LVH的早期明确诊断。Objective To investigate the value of deepest S wave(S_D)and Sv4 of electrocardiogram in diagnosing hypertension with left ventricular hypertrophy(LVH).Methods 100 patients with hypertension admitted to our hospital from August 2022 to July 2024 were selected as subjects and divided into normal group(n=72)and LVH group(n=28)according to complication of LVH or none.All enrolled patients underwent echocardiography and ECG,and the value of S_Dand Sv4 in diagnosing hypertension with LVH was analyzed.Results LVDd,IVST,PWT and LVMI in normal group were lower than LVH group,LVEF was higher than LVH group(P<0.05).S_D,S_D+Sv4,Ravl+Sv3 and Svl+Rv5 in normal group were lower than those in LVH group(P<0.05).When S_Dwas 1.53 mv,the AUC,sensitivity and specificity for the diagnosis of hypertension with LVH were 0.871(95%CI:0.789~0.930),81.43%and 95.83%,respectively.When S_D+Sv4was 1.97 mv,the AUC,sensitivity and specificity in the diagnosis of hypertension with LVH were 0.915(95%CI:0.842~0.961),89.29%and 84.72%,respectively.When Ravl+Sv3 was 1.73 mv,the AUC,sensitivity and specificity in the diagnosis of hypertension with LVH were 0.829(95%CI:0.741~0.897),58.33%and 96.43%,respectively.When Svl+Rv5 was 2.64 mv,the AUC,sensitivity and specificity in the diagnosis of hypertension with LVH were 0.828(95%CI:0.740~0.899),78.57%and 79.17%,respectively.No significant difference showed in the AUC of S_D,S_D+Sv4,Ravl+Sv3 and Svl+Rv5 in the diagnosis of hypertension with LVH(P>0.05),but the sensitivity of S_D+Sv4 was higher than that of S_D,Ravl+Sv3 and Svl+Rv5.Conclusions ECG is a safe and simple method for the diagnosis of hypertension with LVH,S_D+Sv4 is suitable for early diagnosis of LVH.

关 键 词：心电图 最深S波 Sv4 高血压伴左心肥厚 

分 类 号：R544.1[医药卫生—心血管疾病]