左心室肥厚心电图诊断标准分析

目的:对比左心室肥厚心电图诊断标准的敏感性和特异性,以评价不同标准的诊断价值.方法:分析364例原发性高血压患者的超声心动图及心电图检查结果.以超声心动图对患者左心室肥厚情况的检查结果为参照,求得不同心电图标准(Sokolow-Lyon标准、Comell标准、Romhilt-Estes评分、Framingham标准及Perugia标准)诊断左心室肥厚的敏感性和特异性.结果:5项心电图诊断标准的敏感性均＜50%;而特异性较高,除Perugia标准外,余4项标准均＞90%.Perugia标准的敏感性最高41%,特异性低89%;Sokolow-Lyon标准的敏感性22%及特异性93%均较低.结论:心电图诊断左心室肥厚的特异性高、敏感性稍差.Perugia标准是Comdl标准、左心室劳损改变、Romhilt-Estes评分等标准有机的结合,因此提高了心电图诊断的敏感性,而特异性未受到明显影响.

Comparison of Electrocardiographic Criteria for Diagnosis of Left Ventricular Hypertrophy

Objective:To evaluate different standard echocardiogram criteria in their sens itivity and specificity for the diagnosis of left ventricular hypertrophy. Methods: We examined the findings on echocardiogram and echocardiography of 364 essential hypertensive subjects. Left ventricular hypertrophy diagnosed by echoc ardiography was used as references to test the sensitivity and specificity of di fferent echocardiogram criteria (Sokolow-Lyon criteria, Cornell crit eria, Romhilt-Estes score, Framingham criteria and Perugia score). Results: Sensitivity was<50% for all the 5 tested criteria, but specificity wa s higher(>90%) except the Perugia score. The Perugia score had a highest sensiti vity (41%) and a less specificity (89%). Sokolow-Lyon criteria showed both a lo w sensitivity (22%) and a low specificity (93%). Conclusions: Echocardiogram is a specific, but not a sensitive tool for diagnosi s of left ventricular hypertrophy in subjects with essential hypertension. Howev er, an increased sensitivity of standard echocardiogram for detection of left ve ntricular hypertrophy can be achieved by the Perugia score, which incorporates C ornell voltage,Romhilt-Estes and LV strain.This combination improves echocardi ogram specificity,whereas the specificity is not affected.