摘要
目的:研究体表心电图(sECG)对不同类型心肌病合并高血压(EH)患者的诊断价值。方法:根据心肌病类型,我院的109例心肌病合并EH患者被分为扩张型心肌病(DCM)合并EH组(DCM+EH组,59例)与缺血型心肌病(ICM)合并EH组(ICM+EH组,50例)。两组均行sECG检查,比较两组最大T波峰-末间期(Tp-e)、矫正Tp-e间期(cTp-e)、最小Tp-e、各导联Tp-e及sECG其他检查结果。分析sECG对心肌病合并高血压的诊断价值。结果:与DCM+EH组比较,ICM+EH组最大Tp-e[(111.63±9.49)ms比(97.64±5.33)ms]、cTp-e[(87.55±8.05)ms比(78.08±4.79)ms]、最小Tp-e[(57.90±6.40)ms比(51.98±3.52)ms]、V5 Tp-e[(74.52±5.32)ms比(61.35±4.05)ms]、V6 Tp-e[(73.27±5.61)ms比(58.38±4.02)ms]、I导Tp-e[(75.37±8.94)ms比(63.12±4.52)ms]、II导Tp-e[(75.32±10.39)ms比(58.37±5.39)ms]、III导Tp-e[(70.41±9.57)ms比(64.39±6.32)ms]、aVR Tp-e[(75.34±7.52)ms比(64.63±6.98)ms]、aVF Tp-e[(73.23±5.61)ms比(60.29±3.42)ms]均显著降低,QRS时限异常比例(3.39%比18.00%)、左室异常高压比例(3.39%比18.00%)、心律失常比例(6.77%比24.00%)均显著升高,P<0.05或<0.01。II导Tp-e、异常Q波、T波倒置及三者联合检测诊断心肌病合并高血压的ROC曲线下面积分别为0.811、0.748、0.702及0.912,敏感度分别为84.51%、79.13%、76.67%及91.49%,特异性分别为78.68%、67.89%、71.21%及89.46%。结论:sECG的不同表现对不同类型心肌病合并高血压有鉴别诊断价值,值得推广。
Objective:To study differential diagnostic value of surface ECG(sECG)for patients with different types of cardiomyopathy(CM)complicated hypertension(EH).Methods:According to cardiomyopathy type,a total of 109 CM+EH patients treated in our hospital were divided into dilated cardiomyopathy(DCM)+EH group(n=59)and ischemic cardiomyopathy(ICM)+EH group(n=50).sECG examination was performed in both groups.Maximum T wave peak-to-end interval(Tp-e max),corrected Tp-e(cTp-e),minimum Tp-e(Tp-e min),Tp-e of each lead and sECG other results were compared between two groups.Differential diagnostic value of sECG for CM+EH were analyzed.Results:Compared with DCM+EH group,there were significant reductions in Tp-e max[(111.63±9.49)ms vs.(97.64±5.33)ms],cTp-e[(87.55±8.05)ms vs.(78.08±4.79)ms],Tp-e min[(57.90±6.40)ms vs.(51.98±3.52)ms],Tp-e in lead V5[(74.52±5.32)ms vs.(61.35±4.05)ms],V6[(73.27±5.61)ms vs.(58.38±4.02)ms],I[(75.37±8.94)ms vs.(63.12±4.52)ms],II[(75.32±10.39)ms vs.(58.37±5.39)ms],III[(70.41±9.57)ms vs.(64.39±6.32)ms],aVR[(75.34±7.52)ms vs.(64.63±6.98)ms]and aVF[(73.23±5.61)ms vs.(60.29±3.42)ms],and significant rise in percentages of abnormal QRS duration(3.39%vs.18.00%),abnormal left ventricular hypertension(3.39%vs.18.00%)and arrhythmia(6.77%vs.24.00%)in ICM+EH group,P<0.05 or<0.01.AUC of lead II Tp-e,abnormal Q wave,T wave inversion and triple detection in diagnosing CM+EH was 0.811,0.748,0.702 and 0.912 respectively,sensitivity was 84.51%,79.13%,76.67%and 91.49%respectively,and specificity was 78.68%,69.89%,71.21%and 89.46%respectively.Conclusion:The different manifestations of sECG are helpful for the differential diagnosis of different types cardiomyopathy complicated with hypertension.
作者
张倩
雷婷婷
ZHANG Qian;LEI Ting-ting(ECG Room,215 th Hospital of Shaanxi Nuclear Industry,Xianyang,Shaanxi,712000,China)
出处
《心血管康复医学杂志》
CAS
2021年第4期478-481,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌疾病
高血压
心电描记术
Cardiomyopathies
Hypertension
Electrocardiography
