心电图诊断左室肥大的标准化探讨

Investigation of the diagnostic standardization of left ventricular hypertrophy by ECG

目的探讨心电图诊断左室肥大的标准化。方法通过心电网络信息系统回顾常州二院阳湖院区的心电图图文报告,对比心超结果探讨左室肥大(左室肥厚和(或)左室扩大)的心电图诊断标准。结果认为以左室高电压伴ST-T改变为必要条件诊断左室肥大较合适(检出率69.39%,符合率55.68%);若合并电轴左偏和(或)QRS≥100 ms,则诊断符合率明显增高。结论单纯左室肥厚仅表现左室高电压伴ST-T改变;而左室高电压伴ST-T改变合并电轴左偏的情况下,左室肥厚与左室扩大可能相当;左室高电压伴ST-T改变合并QRS≥100 ms则以左室扩大为主。

Objective To investigate the diagnostic standardization of left ventricular hypertrophy by electrocardiogram（ECG）. Methods With ECG network information system in Yanghu District of the Second People＇ s Hospital of Changzhou, retrospectively analyse ECG graphic reports from January 2012 to March 2013. Comparing ECG results with corresponding echocardiographic reports, study the diagnostic criteria of left ventricular hypertrophy （ including left ventricular pachynsis and/or left ventricular enlargement） by ECG. Results The study suggests that it＇ s appropriate to regard left ventricular high voltage with ST-T changes as a necessary condition for the diagnosis of left ventricular hypertrophy（positive rate was 69.39% while coincidence rate was 55.68% ）. The coincidence rate shows a significant increase if the necessary condition is combined with left axis deviation and/or QRS I〉 100 ms. Conclusion Simple left ventricular hypertrophy only represents as left ventricular high voltage with ST-T changes. If left axis deviation is combined with the above representation, the incidence of left ventricular pachynsis and left ventricular enlargement may be equal. If QRS ≥ 100 ms is combined, it mainly implies left ventricular enlargement.