肺心病右房肥大心电向量图诊断标准研究

Study on the Criteria for Vectorcardiographic Diagnosis of Right Atrial Hypertro-phy in Cor Pulmonale

对50例肺心病、32例肺气肿、143例正常成人心电向量图P环18项指标进行了系统性研究,取额面P环最大向量振幅>0.18V及其最大向量角>85°、横面P环顺钟向运转及其最大向量角≥55°、Z轴P波振幅≥0.05mV五项指标组成右房肥大诊断标准,二项或多项阳性可确诊.其对肺心病诊断敏感性为56%,对肺气肿和正常成人诊断特异性分别为96.9%及97.9%.

Eighteen parameters of the p loops of vectorcardiogram in 50 patients with cor pulmonale, 32 patients with emphysema, and 143 normal sub-jects were systemically studied. The criteria for diagnosis of right atrial hypertrophy were constitued with following five indexes (1) the maglitude of maximal p vector in frontal plane exceeded 0. 18mV; (2) the maglitude of p wave in Z axis was eqaul to or greater than 0. 05 mV. (3) the maximal angle of p vector in frontal plane exceeded 85 degrees. (4) the maximal angle of p vector in horizontal plane was equal to or greater than 55 degrees. (5) the p loop in horizontal plane was rotated in clockwise. The right atrial hypertrophy was considered to be present when two or more criteria were positive. Application of those criteria achieved 56% sensitivity in patients with chron-ic cor pulmonale. The specificity in patients with emphysema and normal subjects were 96.9% and 97. 9% respectively.