摘要
目的探讨心电向量图(VCG)对高血压左室肥厚(LVH)的诊断意义以及LVH的相关危险因素,为高血压社区防治中对LVH的筛查、随访提供参考。方法入选2012年2月—2013年2月就诊于我院的原发性高血压病患者770例,以超声心动图(UCG)测出的左心室重量指数为诊断LVH的标准,对770例患者的VCG测定结果进行分析,分别对UCG、VCG诊断出LVH患者相关因素进行单因素及多因素Logistic回归分析。结果以UCG为金标准,VCG检出LVH的敏感度为70.94%(376/530),特异度为74.17%(178/240),准确性为71.95%(554/770)。对VCG与UCG诊断的LVH患者分别进行单因素分析,两种方法均筛选出13个有意义的LVH危险因素。按VCG诊断结果将有统计学意义的指标进行多因素Logistic回归分析,筛选出6个有意义的独立因素:病程、服药规律、收缩压标准差、高同型半胱氨酸血症、颈动脉内膜中层厚度及踝臂脉搏波传导速度(OR值分别为3.299、2.021、1.801、1.019、1.321、1.062)。结论 VCG在社区中对高血压LVH的筛查不受仪器及操作者等条件的限制,且敏感度高,可应用于高血压社区防治中对LVH的筛查、随访。
Objective To explore the diagnostic significance of vectorcardiography （VCG） for hypertensive left ven- tricular hypertrophy （LVH） and the related risk factors, so as to provide a reference for screening and follow - up of LVH in pre- vention and control of hypertension in community. Methods From February 2012 to February 2013 a total of 770 essential hyper- tension patients in our hospital were examined with ultrasonic cardiogram （UCG） for measurement of left ventricular mass index as a diagnostic criterion for LVH, and the VCG test results of 770 patients were analyzed. Then the relevant factors for diagnosis of LVH with UCG and VCG were analyzed using univariate and multivariate Logistic regression analyses. Results Taking UCG as the golden criteria, the sensibility of VCG for detection of LVH was 70. 94% （376/530）, the specificity was 74. 17% （ 178/ 240）, and the accuracy was 71.95% （554/770） . The univariante logistic regression analysis showed than for both VCG and UCG there were 13 screened risk factors to LVH. According to the diagnostic results with VCG, the multivariate Logistic regres- sion analysis revealed 6 independent significant factors including course, regularly taking in the medicine, standard deviation of systolic blood pressure, hyperhomocysteinemia, thickness of common carotid artery intima - media, and conduction velocity of anlde-brachialpulsation （OR=3.299, 2.021, 1.801, 1.019, 1.321, 1.062） .Conclusion TheVCGhasahighsensi- bility and no limit in both instruments and operators in screening LVH of hypertension in community, so it is suitable for screening and follow - up of LVH in prevention and control of hypertension in community.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第34期4041-4043,共3页
Chinese General Practice
关键词
心电向量图
社区预防
高血压
左室肥厚
Vectorcardiography
Community prevention
Hypertension
Left ventricular hypertrophy
