V_1、V_2、V_3的S波及Ⅰ、Ⅱ、aVL的R波之和在诊断左室肥大中的价值

目的探讨诊断左室肥大(LVH)新的心电图指标。方法以超声心动图测定的左室重量(LVM)及重量指数(LVMI)为对照,其诊断LVH的标准为>125g/m2(男),120g/m2(女),对100例正常健康人及111例患者进行了观察,对12导联QRS总振幅(∑QRS)、V1～V3导联的S波之和(∑SV1～V3)、Ⅰ、Ⅱ、aVL导联的R波之和(∑RⅠ、Ⅱ、aVL)及后两者之和(Z表示),分别进行了测定。寻找新指标的正常值范围以及以此标准为依据,诊断LVH的灵敏度、特异度、准确率。结果正常组中,∑QRS、∑SV1～V3、∑RⅠ、Ⅱ、aVL及Z值正常范围分别为77～175,11～38,5～23及22～54mm,以大于这些指标的正常值上限为标准,其诊断LVH灵敏度、特异度及准确率较传统指标明显提高,其中Z值>54mm灵敏度最高(86.54%),准确率最高(90.09%),而特异度仍保持在93.22%。结论LVH新的心电图指标具有一定诊断价值,其中Z>54mm最好。

Development and evaluation of eletrocardiographic diagnostic indexes for left ventricular hypertrophy

Objective To seek for new eletrocardiographic(ECG)indexes for left ventricular hypertrophy(LVH).Methods 100 normal subjects and 111 patients were studied,the ECG findings of LVH were compared with echocardiographically determined LVH(LVMI>125 g/m2 in male,>120 g/m2 in female)to assess the accuracy of various ECG criteria for LVH,of which,the 12-leads total QRS amplitudes(∑QRS),the sum of voltage in SV1～V3(∑SV1～V3),in RⅠ、Ⅱ、aVL(∑RⅠ、Ⅱ、aVL)and the sum of the latter two(i.e.Z=∑SV1～V3+∑RⅠ、Ⅱ、aVL)were measured respectively.Results From normal subjects,the normal range(NR)of ∑QRS,∑SV1～V3,∑RⅠ、Ⅱ、aVL and Z were 77-175,11-38,5-23,22-54 mm respectively.According to upper limit of NR,∑QRS>175 mm,∑SV1～V3>38 mm,∑RⅠ、Ⅱ、aVL>23 mm,and Z>54 mm,were selected as new ECG indexes for LVH.After comparison and analysis with echocardiogram and ECG,it was discovered that the sensitivity and overall accuracy of these new ECG indexes were significantly improved while comparing with the conventional ECG criteria.Among all the criteria and indexes,the Z>54 mm had the highest sensitivity(86.54%),highest accuracy(90.09%)and a specificity of 93.22%.Conclusion These new ECG indexes for LVH are better than the traditional ECG criteria,the Z>54mm is the best one.