应用Peguero-Lo Presti指数诊断左心室肥厚伴完全性右束支传导阻滞的价值

Value of Peguero-Lo Presti Index in the diagnosis of left ventricular hypertrophy with complete right bundle branch block

目的:分析应用Peguero-Lo Presti指数诊断左心室肥厚(LVH)伴完全性右束支传导阻滞(CRBBB)的价值。方法:选取271例CRBBB患者,进行心电图、超声心动图检查,以超声心动图结果作为金标准,分为LVH阳性组和阴性组,分析评价心电图各参数SV1、SV2、SV3、SV4、SV5、SV6、SD、RaVL、RV5、及RV6振幅、QRS波群时限、QTc间期,Peguero-Lo Presti指数(SV4+SD)、Sokolow指数(SV1+RV5)、Cornell指数(SV3+RaVL)诊断LVH合并CRBBB的准确性。结果:SV3、SV4、SV5、SV6、SD、QRS波群时限、QTc间期和Peguero-Lo Presti指数(SV4+SD)均为诊断LVH合并CRBBB的可靠指标;其中Peguero-Lo Presti指数(灵敏度46.2%、特异度77.2%,AUC0.640)准确性高于Sokolow指数(灵敏度5.8%、特异度97.0%,AUC 0.598)和Cornell指数(灵敏度19.2%、特异度95.8%,AUC 0.626)。结论:Peguero-Lo Presti指数是诊断LVH合并CRBBB心电图参数中最准确的,其诊断价值高于Sokolow指数和Cornell指数。

Objective:To evaluate the value of Peguero-Lo Presti index in the diagnosis of left ventricular hypertrophy(LVH)with complete right bundle branch block(CRBBB).Method:The 271 patients with CRBBB were examined by ECG and echocardiography.The results of echocardiography were divided into LVH positive group and LVH negative group.The parameters of ECG such as SV1,SV2,SV3,SV4,SV5,SV6,SD,RaVL,RV5,and RV6 amplitude,QRS wave group time limit,QTc interval,Peguero-Lo Presti index(SV4+SD),Sokolow index(SV1+RV5),Cornell index(SV3)were analyzed and evaluated.Result:SV3,SV4,SV5,SV6,SD,QRS wave group time,QTc interval and Peguero-Lo Presti index(SV4+SD)were reliable indicators for diagnosis of LVH with CRBBB.Peguero-Lo Presti index(sensitivity 46.2%,specificity 77.2%;AUC 0.640)was more accurate than Sokolow index(sensitivity 5.8%,specificity 97.0%;AUC 0.598)and Cornell index(sensitivity 19.2%,specificity 95.8%;AUC 0.626).Conclusion:Peguero-Lo Presti index is the most accurate electrocardiogram parameter in the diagnosis of LVH combined with CRBBB.Its diagnostic value is higher than Sokolow index and Cornell index.