记分法判别完全性右束支传导阻滞性质的价值研究

The study of the value of scoring method used in distinguishing the nature of complete right bundle branch block

目的探讨记分法判别完全性右束支传导阻滞(CRBBB)性质的价值。方法比较128例器质性心脏病患者和144例健康人CRBBB相关参数,并按阳性预测值高低赋予不同分值,构成记分法标准。结果记分法构成,CRBBB伴原发性ST-T改变、心电轴左偏<-30°或右偏>+110°、J-Tc间期>0.32s各记5分,QRS波时限≥0.16s记4分,V1导联R峰时间≥0.10s记3分,QRS波时限>0.14s、V5导联S波时限>0.08s、年龄≥60岁各记2分,总积分≥5分者判为病理性CRBBB,<5分者判为功能性CRBBB。单项指标判别CRBBB性质敏感度低(2.34%～83.59%)或特异度不高(22.22%～100.00%),记分法判别CRBBB性质则有较高敏感度(85.16%)、特异度(91.67%)和预测准确性(88.60%)。结论记分法对判别CRBBB性质有较好的临床应用价值。

Objective To study the value of scoring method used in distinguishing the nature of complete right bundle branch block（CRBBB）.Methods The CRBBB relevant parameters of 128 cases organic heart disease patients and those of 144 cases of healthy people were compared.Results The compositions of scoring method are：CRBBB with primary ST-T change、 Cardiac electric axis left deviation-30°or right deviation＋110°、J-Tc interval0.32s（five points for each）,QRS wave time≥0.16s（four points）、QRS wave time0.14s、V1lead R peak time≥0.10s（three points）,V5 lead S wave duration0.08s、age≥60 year（two points for each）,total score≥5 points,it will be judged as pathological CRBBB,if it is 5,it will be judged as functional CRBBB.Using the single index to distinguish CRBBB led to low sensitiveness（2.34%～83.59%） and specificity（22.22%～100.00%）,while using the scoring method generated high sensitiveness（85.16%） and specificity（91.67%）,as well as higher accuracy（88.60%）.Conclusions The scoring method is a good way of distinguishing the nature of CRBBB in clinical application.