左前分支阻滞合并左心室肥厚的心电图诊断

The diagnostic value of EKG for left anterior hemiblock with left ventricular hypertrophy by EKG

目的探讨诊断左前分支阻滞合并左心室肥厚(LAFB+LVH)的心电图诊断指标。方法对心电图示左前分支阻滞患者依据超声心动图诊断分为LAFB+LVH为观察组(n=58)与单纯完全性左前分支阻滞(LAFB)对照组(n=50),并选择电轴左偏(LAD)的正常体检者为正常组(n=50)。分析心电图各项左心室肥大指标及SⅢ+胸导最大(R+S)振幅≥3.0Mv标准的敏感性、特异性及准确性。结果观察组SⅢ+胸导max(R+S)均值明显高于对照组,其敏感性、特异性及准确性分别为91.37%、92.00%和91.67%。而其他电压指标的均值均低于诊断LVH的老指标。观察组QRS时限≥0.11 s的敏感性70.69%。特异性100%。结论 LAFB时,SⅢ+胸导最大(R+S)振幅≥3.0 Mv标准结合QRS时限≥0.11 s指标可提高心电图对左室肥大诊断的准确率。

Objective To evaluation on the diagnostic value of left anterior fascicular block（LAFB）with left ventricular hypertrophy（LVH）by EKG.Methods The patients were divided into LAFB＋LVH group（n=58）,LAFB group（n=50）and normal group（n=50）on UCG.P wave,QRS complex interval,QRS axis,amplitude of RⅠ,SⅢ,RaVL,RV5（6）,RV5（6）＋SV1 were measured,and SⅢ＋（precordial R＋S）max,those indexes with that in these groups were compared.Results The average value of SⅢ＋（precordial R＋S）max in LAFB＋LVH group was higher than that in LAFB group and normal group,its sensitivity,specificity and accuracy of those indexes were 92.37%,92.00% and 91.67%,respectively.The specificity of QRS time in LAFB＋LVH≥0.11S was 100%.Conclusion Those are effective parameters for the diagnosis of left ventricular hypertrophy in the presence of left anterior hemiblock.