心电指标对新标准左室肥厚的诊断价值探讨

Investigate the diagnostic value of ECG indicators for new standard left ventricular hypertrophy

目的:探讨左室肥厚诊断标准提前后,心电图常用LVH指标在诊断LVH中的价值。方法:选取2014年1月至2014年12月在我院同期行常规心电图及心脏彩超检查患者309例根据心脏超声检查室间隔厚度(IVST)或左室后壁厚度(LVPWT)≥11mm(男性)和≥10mm(女性)为标准分为两组:左心室肥厚(left ventricular hypertrophy,LVH)组(观察组,n=203)、非肥厚组(对照组,n=86)。观察两组心电图常用心室肥厚指标差异及常用指标在观察组的敏感性、特异性、准确率。收集2009年9月至2005年12月按超声诊断标准(男性IVST或LVPWT≥12mm,女性IVST或LVPWT≥11mm)诊断LVH病例145例(旧标准组,n=145),观察心电指标在新旧超声标准LVH预测中的差异。结果:心电图电压指标在观察组敏感性,诊断准确性降低,尤其是电压指标;诊断准确性以QRS电轴<30°、QRS时间≥100ms、左心房异常、ST-T异常、VAT≥40ms、Z值相对较好。结论:心电图常用电压指标在新标准LVH诊断价值有限,寻找新的便于操作指标或调整原有参数的标准很有必要;作为筛查,多指标联合应用可提高心电图在LVH诊断价值。

Objective： To investigate the value of LVH index in diagnosis of LVH after diagnosis of left ventricular hypertrophy. Methods： From January 2014 to December 2014,309 patients underwent routine ECG and cardiac color Doppler ultrasonography according to the thickness of ventricular septum（ IVST） or left ventricular posterior wall thickness（ LVPWT）≥11mm（ male）（ Left ventricular hypertrophy,LVH） group（ observation group,n = 203）,non-hypertrophic group（ control group,n = 86） were divided into two groups： left ventricular hypertrophy（ LVH） and ≥10 mm（ female） To observe the difference of common ventricular hypertrophy between the two groups and the sensitivity,specificity and accuracy of the commonly used indexes in the observation group. Collected from September 2009 to December 2005 by ultrasound diagnostic criteria（ male IVST or LVPWT ≥12mm,female IVST or LVPWT ≥11 mm） diagnosis of LVH cases 145 cases（ old standard group,n = 145）,observed ECG indicators in the Differences in LVH prediction between old and new ultrasound standards.Results： ECG voltage index in the observation group sensitivity,diagnostic accuracy,especially the voltage index; diagnostic accuracy to QRS axis 〈 30°,QRS time≥100ms,left atrial abnormalities,ST-T abnormal,VAT≥40ms,Z The value is relatively good. Conclusion： ECG commonly used voltage index in the new standard LVH diagnostic value was limited,to find a new easy to operate indicators or adjust the original parameters of the standard was necessary; as a screening,multi-index combination of applications can improve the value of ECG in LVH diagnosis.