心电图不同标准诊断左室肥厚的敏感性分析

摘要

Objective To explore the value and clinical significance of two electrocadiogram QRS voltage criteria (Cornell and Sokolow-lyon) in diagnosing of essential hypertension(EH) with left ventricular hypertrophy(LVH). Methods LVH were defined by left ventricular mass index(LVMI)>125 g/m2 in men and LVMI>110 g/m2 in women. The vohages of Sokolow-lyon criteria (SVl + Rv5 >40mm in men or SVl + Rv5>35mm in women) and Cornell criteria (RaVL+Sv3). QRS duration>2440 mm. Ms in men and (RaVL+Sv3). QRS duration> 2440mm. Ms in women. The voltage electrocardiogram (ECG)were measured in 90 cases of EH with LVH confirmed by ultrasonic cardiogram (Group A)and 81 cases of EH without LVH (Group B). The sensitivity and specificity of them were calculated. Results The sensitivity and the specificity in diagnosis of EH with LVH were compared with those with Sokolow-lyon criteria and Cornell criteria. The diagnositic sensitivity of Sokolow-lyon criteria and Cornell criteria were 36. 7% and 62. 2% respectively. The specificity were 96.2% and 95.1%; There was significant difference between two groups, sensitivity (P< 0. 05). Conclusion The sensitivity of Sokolow-lyon criteria is lower than Cornell criteria in diagnosis of LVH.%目的 以超声心动图法(UCG)诊断左室肥厚(LVH)为标准,探讨心电图(ECG) QRS两种电压标准(Sokolow-Lyon标准及Cornell标准)在原发性高血压(EH)左室肥厚诊断中的价值及临床意义.方法 按照UCG左室重量标准,男性LVMI＞125g/m2,女性LVMI＞110g/m2作为LVH诊断标准; ECG按照Cornell标准:(RaVL+ Sv3).QRS间期时限,男性＞2440 mm·ms,女性＞2440mm·ms; Sokolow-Lyon标准:Sv1+ Rv5男性＞40mm,女性＞35mm,作为诊断LVH的标准.根据UCG阳性进行分组,测量有EH伴LVH者90例(A组)及有EH无LVH者81例(B组)的Sokolow-Lyon标准和Cornell标准,分别计算Sokolow-lyon标准和Cornell标准诊断LVH的敏感性和特异性.结果 Sokolow-Lyon标准和Cornell标准诊断LVH的价值比较:敏感性分别为36.7％和62.2％,具有统计学差异(P＜0.05);特异性分别为96.2％及95.1％,无统计学差异(P＞0.05).结论 心电图在诊断LVH中,Sokolow-Lyon标准较Cornell标准敏感性低,建议采用Corenell标准,凡有务件者应再行UCG检查,以提高LVH的检出率.