急性心肌梗死合并左束支传导阻滞的心电图诊断

目的 评价Sgarbossa方案在诊断左束支传导阻滞合并心肌梗死的实用性。方法 收集可疑有急性心肌梗死的左束支传导阻滞患者64例,以心肌酶学指标作为急性心肌梗死确诊的客观标准,比较Sgarbossa方案和传统心电图诊断方案在诊断急性心肌梗死中的敏感性、特异性、阳性预测率、阴性预测率等。结果 Sgarbossa方案在诊断合并左束支传导阻滞的急性心肌梗死的敏感性、特异性、阳性预测率、阴性预测率分别为55.2％、94.2％、88.1％、71.1％;传统方案为62.6％、80.6％、72.0％、71.1％。两者相比在特异性、阳性预测率方面,Sgarbossa方案优于传统方案,统计学有显著差异(P<0.05)。结论 临床上在Sgarbossa方案的基础上结合传统心电图鉴别诊断指标综合判断可能会提高诊断的敏感性。

ECG Diagnosis of Acute Myocardial Infarction Patients with Left Bundle Branch Block

Objective In order to appraise practicality of Sgarbossa criterion in diagnosing acute myocardial infarction( AMI) with left bundle branch block(LBBB). Methods 64 patients suspected AMI with left bundle branch block were collected, The sensitivity, speciality, positive predective value(PPV)and negative predective value (NPV)of two diagnostic methods were compared by using objective criterion of myocardial enzyme. Result The sensitivity,speciality, PPV, NPV, of Sgarbossa criterion are 55.2% ,94.2% ,88.1% ,71.7% respectively. Those of traditional criterion separaely is 62.6% , 80.5% ,70.0%, 71.1% . There is famously statistical difference in the speciality and PPV between two criteria ( P < 0.05) . There is not any statistical difference in other indexes. Conclusion It was suggested that general differenciating diagnosis based on Sgarbossa and traditional ECG criterion probably improve the sensitivity of diagnosis of AMI with LBBB.