心电图诊断高血压左心房扩大的价值及其方法学探讨

目的探讨心电图P波宽度,切迹峰距,PV1负向波深度与宽度及P/PR指数对高血压左心房扩大的诊断敏感性和特异性。方法取经超声心动图检查确诊已有左心房扩大和无左心房扩大的高血压病患者各100例进行回顾性心电图分析,分别计算各项指数诊断左心房扩大的敏感性和特异性。结果各项指标中有四项指标病例组与对照组之间差异有显著性(P<0.01),其中最敏感的指标是PV1负向波增宽(>0.04s),敏感性84%;最具特异性指标是P波增宽有切迹,峰距>0.04s,特异性93%。结论心电图出现PV1负向波增宽、加深,P波增宽且有切迹等多项指标异常时,不失为诊断高血压左心房扩大的有效方法之一。

How to Apply and Evaluate ECG Criteria for Left Atrial Enlargement in Hypertension

Objective To apply body surface electrocardiographic (ECG)values:P-wave width,peak spacing,PV_1 negative component depth and width,P/PR index in hypertension patients and evaluate their sensitivity and specificity for left artria enlargement.Methods 200 hypertension patients,data were reviewed,100 cases with left atrial enlargement confirmed by echocardiography,other 100 cases without left atrial enlargement in control.Results There were significant difference between two groups in four criteria (P<0.01).The negative component widened(>0.04 s)was the most sensitive criterion,its sensitivity was 84%.The P-wave widened with incisure,peak spacing>0.04 s was the most specificity criteria,its specificity was 93%.Conclusion All ECG diagnosis criteria for left atrial enlargement are effectual.