常规导联与头胸导联对急性右心室梗死心电图诊断的比较

Comparison between the head-chest lead electrocardiogram and routine lead electcaiogram in diagnosingacute right ventricular infarction

目的观察在对急性右心室梗死心电图诊断方面,头胸导联是否具有与常规导联一样的价值。方法对于正常人和经冠状动脉造影确诊的急性右心室梗死患者,同步记录常规及其右胸导联心电图和头胸导联心电图各一份,由两位不知情的资深电生理医生进行分析诊断。而后由观察者将两种体表心电图的诊断结果与冠脉造影的结果、以及正常人的结果相对照,分别计算出两种导联系统对急性右心室梗死心电图诊断的准确率和假阳性率,并作卡方检验进行比较。结果本实验包括由全国十二家大医院提供的急性右心室梗死患者42例,和正常人58例。常规导联对急性右心室梗死的心电图诊断准确率为83.3%(35/42)、假阳性率32.7%(19/58);而头胸导联的诊断准确率为95.2(40/42)、假阳性率0%(0/58)。头胸导联诊断急性右心室梗死的准确率高于常规导联,假阳性率低于常规导联,两者皆有统计学上的显著差异(P<0.05)。结论在对急性右心室梗死患者的诊断方面,头胸导联优于常规导联。

Objective To observe whether there was difference between the head -chest lead electrocardiogram （HCECG） and the routine leads electrocardiogram （RLECG） in diagnosis of patients with acute right ventricular infarction （ARVI）. Methods HCECGs and RLECGs were recorded simultaneously in 58 normal persons and 42 patients with ARVI, which had been confirmed by coronary angiography. Each HCECG and RLECG was analyzed by the same senior physicians in clinical electrophysiology who knew nothing about the results. Then the diagnostic results of the HCECGs and RLECGs were compared with the true checking results. And the chi - square test was performed to observe if there was statistical difference between the HCECGs and RLECGs in diagnosis of patients with ARVI. Results The accurate rate in diagnosis of ARVI was 83.3% （35/42）in RLECGs, 95.2% （40/42）in HCECGs, and the false positive rate was 32.7% （19/58） in RLECGs, 0% （0/58） in HCECGs respectwely. There is both statistical significance between two methods （P 〈 0.05）. Conclusion Head - chest lead system seemed to be better than routine lead system in diagnosis of the patients with ARVI.