老年男性心电图Cornell电压标准及其应用价值

Value of the electrocardiographic Cornell criteria for detecting left ventricular hypertrophy in elderly men

目的探讨老年男性心电图Comell电压标准及其诊断老年男性左室肥厚的价值。方法回顾性分析北京医院自1990年来进行尸体解剖的老年男性患者资料，排除心电图QRS波时限≥0．12s及起搏心电图的患者。测量死亡前3个月内标准12导联心电图QRS波振幅，分析老年男性Cornell、Sokolow．Lyon电压值与左室前壁厚度的相关性。计算老年男性无器质性心脏病组Comell电压值的均数及其97．5％的上限值，分析老年男性心电图Comell电压标准诊断老年男性左室肥厚的敏感性、准确性。结果老年男性心电图Comell、Sokolow-Lyon电压值与左室前壁厚度相关。老年男性无器质性心脏病组心电图SV3＋RaVL平均值为（1．32±0．79）mV，以其97．5％的上限值2．9mV为Comell标准诊断老年男性左室肥厚的敏感性、准确性分别为34．3％、77．5％，高于Sokolow-Lyon标准。结论心电图Cornell电压标准诊断中国老年男性左室肥厚的界值可采用2．9mV，其诊断老年男性左室肥厚的敏感性、准确性高于Sokolow-Lyon标准。

Objective To explore the value of electrocardiographic （ECG） Comell criteria for detecting left ventricular hypertrophy （LVH） in elderly Chinese men. Methods Since 1990, 244 autopsies were performed in our hospital in elderly men, LVH was determined in these autopsy hearts and correlated to ECG LVH signs recorded within 3 months before death according to Cornell （SV3 ＋ RaVL ） and Sokolow-Lyon criteria（ SV1 ＋ RV5 or RV6 ）. The reference value of Cornell criteria was obtained based on values from autopsied healthy hearts, the sensitivity and specificity of Comell and Sokolow-Lyon criteria for detecting left ventricular hypertrophy in these elderly men were calculated. Results There were significantly correlations between QRS amplitudes of Cornell and Sokolow-Lyon criteria and autopsy/eft ventricular wall thickness in these hearts. The reference value of Cornell criteria （ SV3 ＋ RayL ） was 2.9 mV. The sensitivity of Sokolow- Lyon and Cornell criteria for detecting LVH was 25.4% and 34. 3% （P 〈0. 05 vs Sokolow-Lyon criteria）, respectively. Conclusion Voltage （SV3 ＋ RavL ） ≥2. 9 mV might be a suitable diagnostic value for detecting left ventricular hypertrophy in Chinese elderly men.