心电向量图对慢性肺源性心脏病右心室肥厚与扩张的诊断研究

Diagnostic Study of Vectorcardiogram on Right Ventricle Hypertrophy and Dilatation of Chronic Pulmonary Heart Disease

目的:探讨心电向量图(VCG)对慢性肺源性心脏病早期右心室肥厚与扩张的诊断价值。方法:选择我院2015年1月-2016年1月门诊及住院慢性肺源性心脏病患者100例,所有患者进行心电向量图和常规心电图(ECG)检查,比较两种方法对慢性肺心病右心室肥厚与扩张的检出率,以及和超声心动图诊断的符合率,另外对比两种检测方法的检测差异,并进行统计分析。结果:与超声结果对比,ECG的检出率为43.00%(73/100)明显低于VCG的91.00%(91/100),且差异具有统计学意义(X2=36.326,P=0.000);VCG在诊断慢性肺源性心脏病右心室肥厚与扩张方面的敏感性明显高于ECG(P<0.05),而两种检测方法的特异度、假阳性预测值及假阴性预测值之间的差异无统计学意义(P>0.05)。结论:以超声心动图为标准,VCG对于慢性肺源性心脏病早期右心室肥厚与扩张的检出率较高,且具有较高的敏感性,值得在临床上广泛推广应用。

Objective： To investigate diagnostic value of vectorcardiogram （VCG） on chronic pulmonary heart disease of right ventricular hypertrophy and expansion. Methods： 100 cases of patients with chronic pulmonary heart disease were selected from January 2015 tp January 2016 in outpatient and hospitalization. All patients were treated with vectorcardiogram and conventional electrocardiogram （ECG） examination. The detection rate and echocardiographic diagnosis coincidence rate of two methods for right ventricular hypertrophy and expansion was compared, in addition, the differences of two kinds of detection methods were compared, which was analyzed statistically. Results： Compared with the ultrasound results, the detection rate of ECG was 43.00% （43/100）, which was notably lower than 91.00% （91/100） of VCG, and the difference was statistically significant （X^2=36.326, P=0.000）; The sensitivity of VCG in diagnosis of right ventricular hypertrophy and expansion of chronic pulmonary heart disease was obviously higher than that of ECG （P〈0.05）, and the difference of specific degree, the projections false positive and false negative predictive value of two methods had no statistical significance （P〉0.05）. Conclusion： On the basis of echocardiography, the early detection rate of VCG in the right ventricle hypertrophy and expansion of chronic pulmonary heart disease was high, and has high sensitivity,which is worth to be widely applied in clinic.