不同心电图电压标准对高血压左心室肥厚患者的诊断效能比较

Comparison of Diagnostic Efficacy of Different Electrocardiographic Criteria for Hypertensive Patients with Left Ventricular Hypertrophy

【目的】探讨不同心电图电压标准对高血压左心室肥厚患者的诊断效能。【方法】回顾性分析2019年5月至2022年5月本院收治的180例高血压患者的临床资料,所有患者均进行超声心动图和心电图检查,以超声心动图诊断为金标准,采用Kappa检验分析Sokolow-Lyon电压标准、Cornell电压标准、Peguero-Lo Presti电压标准及三种心电图电压标准联合诊断左心室肥厚的灵敏度、特异度、准确率和一致性。【结果】180例高血压患者均进行超声心动图检查,结果显示,左心室肥厚102例(56.67%),非左心室肥厚78例(43.33%)。一致性分析显示:Sokolow-Lyon电压标准诊断左心室肥厚的灵敏度为0.373,特异度为0.821,准确率为0.567(Kappa=0.180,P=0.414);Cornell电压标准诊断左心室肥厚的灵敏度为0.490,特异度为0.872,准确率为0.656(Kappa=0.340,P=0.207);Peguero-Lo Presti电压标准诊断左心室肥厚的灵敏度为0.863,特异度为0.744,准确率为0.811(Kappa=0.612,P<0.001);三种心电图电压标准联合诊断左心室肥厚的灵敏度为0.922,特异度为0.923,准确率为0.922(Kappa=0.842,P<0.001)。【结论】Peguero-Lo Presti电压标准诊断左心室肥厚的灵敏度、准确率、Kappa值优于Sokolow-Lyon电压标准和Cornell电压标准,三种心电图电压标准联合可提高诊断左心室肥厚的灵敏度、特异度和准确率。

【Objective】To explore the diagnostic efficacy of different electrocardiographic criteria for hypertensive patients with left ventricular hypertrophy.【Methods】The clinical data of 180 patients with hypertension admitted to our hospital from May 2019 to May 2022 were retrospectively analyzed.All patients underwent echocardiography and electrocardiography,and the diagnosis of echocardiography was regarded as the gold standard.Kappa test was used to analyze the sensitivity,specificity,accuracy and consistency of Sokolow-Lyon voltage standard,Cornell voltage standard,Peguero-Lo Presti voltage standard and the combination of three ECG voltage standards in the diagnosis of left ventricular hypertrophy.【Results】Echocardiography was performed in 180 patients with hypertension.The results showed that 102 patients(56.67%)had left ventricular hypertrophy and 78 patients(43.33%)had non left ventricular hypertrophy.The consistency analysis showed that the sensitivity of Sokolow-Lyon voltage standard for the diagnosis of left ventricular hypertrophy was 0.373,the specificity was 0.821,and the accuracy was 0.567(Kappa=0.180,P=0.414);The sensitivity,specificity and accuracy of Cornell voltage standard in the diagnosis of left ventricular hypertrophy were 0.490,0.872 and 0.656(Kappa=0.340,P=0.207);The sensitivity,specificity and accuracy of Peguero-Lo Presti voltage standard in the diagnosis of left ventricular hypertrophy were 0.863,0.744 and 0.811(Kappa=0.612,P<0.001);The sensitivity,specificity and accuracy of three electrocardiographic voltage criteria in the diagnosis of left ventricular hypertrophy were 0.922,0.923 and 0.922 respectively(Kappa=0.842,P<0.001).【Conclusion】The sensitivity,accuracy and kappa value of Peguero-Lo Presti voltage standard in the diagnosis of left ventricular hypertrophy are better than Sokolow-Lyon voltage standard and Cornell voltage standard.The combination of three ECG voltage standards can improve the sensitivity,specificity and accuracy in the diagnosis of left ventricular hypertrophy.