Cornell指数和Sokolow指数诊断左室肥大的价值

比较和评估Cornell指数与传统Sokolow指数诊断左室肥大(LVH)的价值,探索进一步提高心电图诊断性能的可能性。以1999～2003年我院体检及住院患者为研究对象,共499例。依据超声心动图测定的左室重量指数(LVMI)分为正常组(男210例、女83例)和LVH组(男126例、女80例)。计算Cornell指数和Sokolow指数的诊断灵敏度、特异度和准确率,以及不同特异度条件下的电压阈值及其相应的灵敏度和准确率。结果:两指数诊断男、女LVH的特异度大体相当,均>95%;男、女性Cornell指数的灵敏度和准确率高于Sokolow指数。把Cornell指数的特异度降为95%时,其诊断准确率可由80%提高到82%;调整电压阈值,Sokolow指数的最高诊断准确率为84%,但其特异度仅为85%。结论:Cornell指数诊断LVH的性能优于Sokolow指数;适当调整电压阈值标准可进一步改善两指数的心电图诊断性能,但改善的空间有限。

The Value of Cornell Index and Sokolow Index on Diagnosis of Left Ventricular Hypertrophy

To compare and evaluate the performance of the Cornell index and Sokolow index for left ventricular hypertrophy (LVH) detection and to find a more effective criterion,overall, 499 cases of inpatient and the persons who had health examinations in the hospital from 1999 to 2003 were identified. Control group (210 cases in male and 83 cases in female) and LVH group (126 cases in male and 80 cases in female) were divided according to the left ventricular mass index (LVMI) determined by echocardiogram. Sensitivity, specificity, accuracy of Cornell index and Sokolow index were calculated. The voltage threshold at different specificity and corresponding sensitivity and accuracy were examined. Results: No significant difference on the specificity for diagnosis of LVH between two indexes was observed for both sexes. The sensitivity and accuracy of Cornell index were higher than Sokolow index for both sexes. Adjusting the specificity of Cornell index to 95%, its accuracy could increase from 80% to 82%. The highest accuracy of Sokolow index was 84% with adjusting the voltage threshold, but its specificity was merely 85%. Conclusion: The performance of Cornell index is better than Sokolow index for LVH detection. Adjusting voltage threshold may further enhance the predictive value of ECG, but the extent of improvement is limited.