心电图与超声心动图诊断原发性高血压导致左室肥厚的对比研究

目的评价心电图Sokolow-lyon标准和Cornell标准在诊断原发性高血压导致左室肥厚中的价值。方法选取2016年1月1日~2016年8月30日在解放军总医院心血管内科住院的高血压患者194例,同时对其行标准12导联心电图和超声心动图检查。以超声心动图左室质量指数(LVMI)作为诊断左室肥厚的参考标准,评估心电图Sokolow-lyon标准和Cornell标准诊断左室肥厚的敏感度、特异度和准确度。结果Sokolow-lyon标准诊断左室肥厚敏感度为28.1%,特异度为95.4%,准确度为73.1%;Cornell标准诊断的敏感度为34.4%,特异度为93.1%,准确度为73.7%;两标准联用时诊断左室肥厚敏感度为45.3%,特异度为90.0%,准确度75.3%。两种标准诊断左室肥厚的特异度和准确度无显著性差异,但Cornell标准的敏感度高于Sokolow-lyon标准(P<0.05)。结论在原发性高血压导致左室肥厚患者的诊断中,心电图Cornell标准较Sokolowlyon标准灵敏度高,两标准联用能提高诊断的灵敏度,并结合患者病史、症状和体征等因素以提高疾病的诊断效率。

The contrast study of electrocardiogram and echocardiogram in the diagnosis of left ventricular hypertrophy caused by hypertension

Objective The aim of this study was to assess the value of Sokolow-Lyon electrocardiogram criteria and Cornell electrocardiogram criteria for the diagnosis of left ventricular hypertrophy caused by primary hypertension. Methods A total of 194 hypertension patients in our hospital were examined by echocardiogram. The diagnosis of left ventricular hypertrophy was based on the left ventricular mass index (LVMI) assessed based on the echocardiogram. The sensitivity,specificity and accuracy of the Sokolow-Lyon criteria and Cornell criteria for reaching the same diagnosis were then evaluated. Results The sensitivities of the Sokolow-Lyon criteria,Cornell criteria and combined Sokolow-Lyon and Cornell criteria for the diagnosis of left ventricular hypertrophy were 28.1%, 34.4% and 45.3%, respectively;the specificities were 95.4%,93.1% and 90.0%, respectively;and the accuracies were 73.1%,73.7%and 75.3%,respectively. Therefore,the Cornell criteria are more sensitive than the Sokolow-Lyon criteria for detecting left ventricular hypertrophy(P<0.05);the specificity and accuracy do not significantly differ between the two criteria. Conclusion The sensitivities of Sokolow-Lyon criteria and Cornell criteria for the diagnosis of left ventricular hypertrophy are low; thus, the clinical significance is limited. To improve the efficiency of diagnosing this disease,we should combine the use of these criteria with some other factors,such as patient medical history,symptoms and signs.