【摘要】 目的探讨改良的Cornell电压对高血压左心室肥厚的诊断价值。方法回顾性纳入高血压患者381例(男233例,女148例),采集并计算其不同心电图指标:改良的Cornell电压(12导联中最大的S波或QS振幅与aVL导联R波振幅之和)、SD(12导联中最大的S波或QS振幅)、Cornell电压(V3导联的S波振幅与aVL导联R波振幅之和)及Sokolow-Lyon电压(V1导联S波振幅和V5或V6导联R波振幅之和)。以超声心动图测定的左心室质量指数(LVMI)作为诊断左心室肥厚(LVH)的金标准,分为无LVH组213例(男143例,女70例)与LVH组168例(男90例,女78例),比较无LVH组与LVH组之间改良的Cornell电压、SD、Cornell电压及Sokolow-Lyon电压及其对LVH的诊断价值。结果与无LVH组比较,LVH组改良的Cornell电压、SD、Cornell电压及Sokolow-Lyon电压均增高,差异有统计学意义(P<0.01)。在男性患者中,改良的Cornell电压诊断高血压合并LVH的曲线下面积(AUC)、截断值及敏感度、特异度分别为0.810、1.60 mV、86.67%、67.83%,改良的Cornell电压诊断LVH的效能优于SD、Cornell电压及Sokolow-Lyon电压(Z分别为2.501、2.616、2.650,均P<0.05)。在女性患者中,改良的Cornell电压诊断高血压合并LVH的AUC、截断值及敏感度、特异度分别为0.737、1.45 mV、70.51%、68.57%,改良的Cornell电压诊断高血压合并LVH的效能优于Cornell电压及Sokolow-Lyon电压(Z分别为2.632和2.404,均P<0.05)。二元Logistic回归分析发现,改良的Cornell电压、舒张压升高为LVH发生的独立危险因素(P<0.01)。结论改良的Cornell电压对高血压LVH的诊断价值优于Cornell电压及Sokolow-Lyon电压。更多还原

【Abstract】 ObjectiveTo explore the diagnostic value of improved Cornell voltage in hypertensive patients with leftventricular hypertrophy(LVH).MethodsData of 381 patients(male 233, female 148) with hypertension wereretrospectively analyzed.The different ECG indicators were collected and calculated including improved Cornell voltage(sum of the maximum S-wave or QS amplitudes in 12 leads and R amplitudes of a VL lead), SD(maximum S-wave or QSamplitude in 12 leads), Cornell voltage(sum of the amplitude of S wave of V3 lead and R wave of a VL lead) and Sokolow-Lyon voltage(sum of the amplitude of the S wave of V1 and the amplitude of R wave of V5 or V6).The left ventricular massindex(LVMI) measured by echocardiography was used as the gold standard for diagnosis of LVH.Patients were divided intono-LVH group(n=213, male 143, female 70) and LVH group(n=168, male 90, female 78).The improved Cornell voltage, SD,Cornell voltage and Sokolow-Lyon voltage were compared between the two groups.The diagnostic value of various indexesfor LVH was also compared between the two groups.ResultsCompared with the no-LVH group, the improved Cornellvoltage, SD, Cornell voltage and Sokolow-Lyon voltage were significantly higher in the LVH group(P<0.01).In malepatients with hypertension, the AUC, cut-off value, sensitivity, and specificity of improved Cornell voltage for the diagnosisof hypertension with LVH were 0.810, 1.60 m V, 86.67% and 67.83%, respectively.The diagnostic efficacy of improvedCornell voltage was better than that of SD, Cornell voltage and Sokolow-Lyon voltage(Z=2.501, 2.616 and 2.650, P<0.05).In female patients with hypertension, the AUC, cut-off value, sensitivity and specificity of improved Cornell voltage fordiagnosis of hypertension with LVH were 0.737, 1.45 m V, 70.51% and 68.57%, respectively.The diagnostic efficacy ofimproved Cornell voltage was better than that of Cornell voltage and Sokolow-Lyon voltage(Z=2.632 and 2.404, P<0.05).Stepwise Logistic regression analysis of binary classification found that improved Cornell voltage and diastolic blood pressurewere independent risk factors of LVH(P<0.01).ConclusionThe diagnostic value of improved Cornell voltage is betterthan Cornell voltage and Sokolow-Lyon voltage in hypertensive patients with left ventricular hypertrophy.更多还原