高血压左室肥厚心电综合电压诊断价值分析

目的 探讨心电图综合电压标准在高血压左室肥厚（LVH）中的诊断价值,为高血压LVH的筛查、诊断和疗效观察提供依据.方法 按照美国超声学会（ASE）推荐使用的操作常规（ASE Convention）检测90例中国高血压LVH患者心脏质量指数（UCG-LVMI）,心电电压各参数反复测3个心动周期,取均值,评价心电图综合电压标准在高血压LVH中的诊断价值.结果 根据Cornell新标准,90例中国高血压LVH患者真阳性发生率为60.0%（男性）和64.4%（女性）,假阴性发生率为40.0%（男性）和35.6%（女性）.临床诊断评价：敏感度RⅠ＋SⅢ 20.0%、RV5＋SV1 36.7%、Ravl＋SV3 62.2%,特异度 RⅠ＋SⅢ 100%、RV5＋SV1 94.5%、Ravl＋SV3 95.5%,准确度RⅠ＋SⅢ 64.0%、RV5＋SV1 69.5%、Ravl＋SV3 82.0%.结论 ECG-Cornell标准诊断高血压LVH的敏感度、特异度和准确度分别为62.2%、95.5%和82.0%.综合电压中Cornell电压诊断的敏感度、特异度和准确度最高,是高血压LVH筛查、诊断、预后的理想指标.

The diagnosis value of the electrocardiography complex voltages in hypertensive left ventricular hypertrophy

Objective To analyze the diagnosis value of the electrocardiography complex voltages in hypertensive left ventricular hypertrophy. Methods UCG-LVMI was measured in 90 Chinese hypertensive LVH patients according to American society of echocardiography （ASE） recommending ASE convention. Average value of ECG voltage parameters were obtained by three cardiac periods, and the diagnostic valued of QRS complex voltage in LVH was assessed. Results According to new Cornell criteria for the detection of LVH, true-pesitive identification ratio was 60%（male） and 64.4%（female）, false-negative occurrence ratio was 40%（male） and 35.6%（female）. The diagnostic sensitivity for LVH was RⅠ＋SⅢ 20.0%, Rv5＋Sv1 36.7%, R,a＋Sv3 62.2%, specificity was RⅠ＋SⅢ 100%, Rv5＋Sv1 94.5%, Rv1＋Sv3 95.5%, accuracy was RⅠ＋SⅢ 64.0%, Rv5＋Sv1 69.5%, Rv1＋Sv3 82.0%. Conclusion For the diagnosis of hypertensive LVH by Comell criteria, the sensitivity, specificity and accuracy are 62.2%, 95.5% and 82.0% respectively. The sensitivity, specificity, accuracy of Cornell criteria for detection hypertensive LVH are the best criteria in complex voltages, it is the ideal index for the detection, diagnosis and prognosis of the hypertensive LVH.