摘要
目的 探讨aVR导联QRS电压改变对支气管哮喘与心源性哮喘鉴别诊断的价值.方法 回顾分析临床已确诊的支气管哮喘69例、心源性哮喘60例和健康成人体检90例,被分成支气管哮喘组、心源性哮喘组和健康体检组,分别测量哮喘病人发病前、发病时及治愈后心电图aVR导联QRS电压,健康体检组则分析最近两次心电图体检结果,并分析其动态变化.检测该新方法鉴别支气管哮喘与心源性哮喘的准确度、特异度和敏感度.结果 心源性哮喘组发病前与发病时,以及发病时与治愈后的aVR导联QRS电压变化明显差异有统计学意义（P=0.035）;支气管哮喘组和健康组aVR导联QRS电压无明显动态改变差异无统计学意义（P=0.185、0.393）.应用新方法鉴别支气管哮喘与心源性哮喘的准确度为91.67％、特异度85.71％、敏感度94.87％、阳性预测值92.50％和阴性预测值90.00％.结论 心源性哮喘aVR导联在发病前、发病时和治愈后的QRS电压动态变化明显,支气管哮喘无此变化.aVR导联QRS电压改变对支气管哮喘与心源性哮喘鉴别诊断具有较好的准确度、特异度及操作简单易行等特点,有较高的临床应用价值.
Objective To investigate the clinical significance of the change of QRS voltage in lead aVR in the differential diagnosis of bronchial asthma and cardiogenic asthma.Methods The QRS voltage in lead aVR of 69 patients with cardiogenic asthma and 60 patients with bronchial asthma were surveyed before onset,after onset and cure of illness,that of 90 normal adults were measured at latest two checkup,and then the results of its change were analyzed.The accuracy rate,sensitivity rate and specificity of this new algorithm in the differential bronchial asthma and cardiogenic asthma were calculated.Results It is obvious to the change of QRS voltage in lead aVR of patients with cardiogenic asthma between before onset and after onset of illness or between after onset and cure of illness,the difference was statistically significant（P =0.035）,while the QRS voltage in lead aVR of patients with bronchial asthma and normal adults were not change,the difference was not statistically significant（P =0.185,0.393）.The accuracy rate of the new algorithm in the differential diagnosis of bronchial asthma and cardiogenic asthma was 91.67%,specificity was 85.71%,sensitivity was 94.87%,and positive predictive value was 92.50% %,negative predictive value was 90.00%.Conclusion The change of QRS voltage in lead aVR of patients with cardiogenic asthma before onset,after onset and cure of illness was obvious,while that of patients with bronchial asthma was not positive.Change of QRS voltage in lead aVR is associated with excellent accuracy rate,sensitivity rate for differential diagnosis of bronchial asthma and cardiogenic asthma.This algorithm is simple and could be easily learned and applied by physician.
出处
《中国基层医药》
CAS
2015年第4期586-588,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
哮喘
心电描记术
Asthma
ElectroCardiography
