左室肥厚心电图标准的评价及_∑QRS的诊断价值(附166例病例分析)

EVALUATION OF 12 LEADS QRS VOLTAGE COMPARED WITH OTHER CRITERIA FOR ELECTROCARDIOGRAPHIC DIAGNOSIS OF LEFT VENTRICULAR HYPERTROPHY

目的：以二维超声心动图（ＵＣＧ）作对照，对诊断左心室肥厚（ＬＶＨ）的心电图（ＥＣＧ）标准进行评价。并探讨１２导联ＱＲＳ总电压（∑ＱＲＳ）的正常值及对ＬＶＨ的诊断价值。方法：以ＵＣＧ测算出左室重量指数（ＬＶＭＩ），区分正常组９４例及ＬＶＨ组１６６例，将∑ＱＲＳ≥１８５ｍｍ做为ＬＶＨ标准，将其与ＲｏｍｈｉｌｔＥｓｔｅｓ（ＲＥ）标准、纽约心脏病学会标准（ＮＹＨＡｃ）、胸导电压标准及其各单项指标对比分析。结果：以∑ＱＲＳ≥１８５ｍｍ为标准诊断ＬＶＨ，各项指标与胸导电压标准相似，两者无显著性差异（Ｐ＞００５），但两者除特异性、阳性正确率外，其它各项指标较综合标准低，且有显著性差异（Ｐ＜００１），其它单项标准的准确性较低。综合标准ＮＹＨＡｃ、ＲＥ标准各项检验指标均较高，两者之间无显著差异（Ｐ＞００５）。结论：∑ＱＲＳ标准对ＬＶＨ的诊断价值与胸导电压标准相似，综合标准准确率高，临床应推广使用。

Objective:To evaluate criteria for electrocardiographic(ECG) diagnosis of left ventricular hypertrophy(LVH),particularly for 12 leads QRS voltage( ∑QRS).Methods:Two hundred and sixty human hearts were divided into the LVH group(166 hearts) and the control group(94 hearts)according to the left ventricular mass index(LVMI) meassured by using ultrasonic cardiography(UCG).The upper limit of ∑ QRS was determined as 185 mm.Results:In comparision with previous chest leads amplitude criterion, ∑QRS seems to be no difference( P >0 05).Both criteria were relatively insensitive than NYHAc and Romhilt Estes(RE) point score system( P <0 01).The single criteria was of limited value. There was no significant difference between NYHAc and RE( P >0 05).Conclusion:Combined criteria is more useful than ∑ QRS as well as chest leads amplitude system.