室速积分法对预激性心动过速的鉴别诊断意义

Differential diagnosis significance of ventricular tachycardia score in preexcited tachycardia

目的:探讨室性心动过速(室速)积分法对预激性心动过速的鉴别诊断意义。方法:选取2010-01-2018-11收集的30例经过心内电生理确诊的预激性心动过速患者发作时的宽QRS波心电图,用室速积分法对预激性心动过速心电图进行评估,分析积分法的单项指标诊断的特异度,计算总积分并分析不同积分诊断的特异度。结果:(1)室速积分法的7项指标特异性都达60%以上,但除V1导联起始为R,Ⅱ导联RWPT≥50ms,房室分离这3项指标有统计学意义外(P<0.05),其余P值都大于0.05。其中房室分离特异度最高,达100%。(2)总积分得0分的为33.3%,积1分的为43.3%,积2分的为23.3%,≥3分的为0%,其特异度分别为66.7%、56.7%、76.7%、100%。结论:(1)积分法7项指标中以房室分离诊断预激性心动过速特异度最高,达100%。(2)室速积分法2分尚不能完全鉴别室速与预激性心动过速,但≥3分特异度为100%,可有效鉴别室速与预激性心动过速,应用室速积分法鉴别这两种心动过速具有较高的临床推广价值。

Objective:To investigate the differential diagnosis significance of preexcited tachycardia by ventricular tachycardia(VT)score.Method:Twelve-lead electrocardiogram(ECG)of 30 patients with preexcited tachycardia diagnosed by intracardial electrophysiology from January 2010 to November 2018 was selected.VT score was used to evaluate patients with preexcited tachycardia,analyze the specificity of single criteria diagnosis to VT score,and calculate total score and analyze the specificity of different score.Result:(1)The specificity of the seven criteria of VT score reached more than 60%.The specificity of AV dissociation was the highest,reaching 100%.(2)Obtained 0 point accounted for 33.3%,1 point for 43.3%,2 points for 23.3%,≥3 points for 0%.The specificity was 66.7%,56.7%,76.7%and 100%,respectively.Conclusion:Among the seven ECG criteria of VT score,the specificity of AV dissociation in the distinguish of preexcited tachycardia reaches 100%.VT sroce 2 points could not completely distinguish preexcited tachycardia form VT,but 3 points can effectively distinguish VT and preexcited tachycardia with 100%specificity.