【摘要】 目的 探讨可穿戴式心音心电记录仪对社区高血压患者左心室肥厚(LVH)的预测价值。方法 选取社区高血压慢病管理患者168例，依据超声心动图结果分为对照组(左心室无肥厚140例)和LVH组(28例)。比较两组一般资料、超声心动图和心音心电相关指标水平。采用多因素Logistic回归模型分析LVH的独立预测因子。采用ROC曲线分析经心动周期校正的心脏电-机械激动时间(EMATc)水平对LVH的预测价值。结果 LVH组年龄、女性占比、体质指数(BMI)高于对照组(P<0.05)。超声心动图指标中，LVH组左室舒张末内径、室间隔、左室后壁厚度大于对照组，左室射血分数低于对照组(P<0.05)。心音心电指标中，LVH组EMATc长于对照组，第四心音(S4)出现患者占比高于对照组(P<0.05)。年龄、女性、BMI、EMATc、S4是发生LVH的独立预测因子(P<0.05)。EMATc预测LVH的AUC为0.725。结论 可穿戴式心音心电记录仪在预测LVH方面有一定的临床实用价值，有助于筛查高危个体，提高基层医疗机构高血压慢病管理水平。更多还原

【Abstract】 Aim To investigate the predictive value of wearable heart sound electrocardiography for community hypertensive patients with left ventricular hypertrophy(LVH). Methods 168 patients with chronic hypertensive diseases in the community were selected and divided into the control group(140 cases without left ventricular hypertrophy) and the LVH group(28 cases) according to the results of echocardiography. The basic data, echocardiography and phonocardiogram data were compared between the two groups. The multivariate Logistic regression model was applied to analyze the independent predictors of LVH. The ROC curve analysis was performed to analyze the predictive value of cardiac cycle time-corrected electromechanical activation time(EMATc) level for LVH. Results The age, female proportion and body mass index(BMI) of the LVH group were higher than those of the control group(P<0.05). In terms of echocardiographic indicators, the left ventricular end diastolic dimension, interventricular septal thickness, left ventricular posterior wall thickness of the LVH group were thicker than those of the control group, and the left ventricular ejection fraction was lower than that of the control group(P<0.05). In terms of heart sound and electrocardiogram indicators, the EMATc of the LVH group was longer than that of the control group, and the proportion of the fourth heart sound(S4) was higher than that of the control group(P<0.05). The age, female, BMI, EMATc, and S4 were independent predictors of LVH(P<0.05). The AUC of EMATc in predicting LVH was 0.725. Conclusion Wearable heart sound electrocardiograph has certain clinical practical value in predicting LVH, which helps screen high-risk individuals and improve the management level of hypertension and chronic diseases in primary medical institutions.更多还原