摘要
目的比较《临床心律失常学》和2009年AHA/ACCF/HRS《心电图标准化与解析的建议与临床应用国际指南》中提出的两种心电图诊断标准(分别称为标准1、标准2)对左前分支阻滞(left anterior fascicular block,LAFB)的检出率及诊断敏感度、特异度。方法回顾性分析我院QRS电轴显著左偏的常规心电图,排除下壁和侧壁心肌梗死、心室预激、完全性右束支阻滞、左心室肥厚。以心电向量诊断为标准,分析两种心电图诊断方法对LAFB的检出率、灵敏度和特异度。结果共入选3503例,心电向量检出1137例,检出率为32.46%;标准1检出1376例,检出率为39.28%;标准2检出2431例,检出率为69.40%。标准1的灵敏度为59.37%,特异度为70.37%;标准2的灵敏度为87.25%,特异度为39.18%。标准1的特异度显著高于标准2(P<0.05),标准2的检出率、灵敏度均显著高于标准1(P<0.05)。结论标准2对单纯LAFB的诊断具有更高的检出率和灵敏度,更适合应用于临床筛查。
Objective To compare the detection rate,sensitivity and specificity of two diagnostic criteria in the diagnosis of left anterior fascicular block(LAFB).The two diagnostic criteria were separately proposed in a book named“Clinical arrhythmology”and“2019 AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram”,namely diagnostic criterion 1 and 2,respectively.Methods A retrospective study was carried out on routine ECGs with QRS axis between-45°and-90°in our hospital.Those individuals with inferior and lateral wall myocardial infarction,ventricular preexcitation,complete right bundle branch block,and ventricular hypertrophy were excluded.Taking vectorcardiogram(VCG)diagnostic criterion as a standard,the detection rate,sensitivity and specificity of the two ECG diagnostic methods for LAFB were analyzed.Results A total of 3503 cases are involved from which VCG detects 1137 cases(32.46%),diagnostic criterion 1 detects 1376 cases(39.28%),and diagnostic criterion 2 detects 2431 cases(69.40%).The sensitivity and specificity of diagnostic criterion 1 are separately 59.37%and 70.37%while those of diagnostic criterion 2 are 87.25%and 39.18%,respectively.The specificity of diagnostic criterion 1 is significantly higher than that of diagnostic criterion 2(P<0.05),however,the detection rate and sensitivity of the latter is significantly higher(P<0.05).Conclusion The diagnostic criterion 2 is more suitable for pure LAFB screening because of its higher detection rate and sensitivity.
作者
廉湘琳
徐金义
邱妍妍
Lian Xiang-lin;Xu Jin-yi;Qiu Yan-yan(Department of Cardiac and Pulmonary Function,Henan Provincial People’s Hospital,Zhengzhou Henan 450003,China)
出处
《实用心电学杂志》
2020年第4期269-272,共4页
Journal of Practical Electrocardiology
基金
河南省卫生厅科技攻关资助项目(CYQ20160058)。
关键词
心电数据云平台
单纯左前分支阻滞
诊断标准
心电图
心电向量图
ECG data cloud platform
pure left anterior fascicular block
diagnostic criterion
electrocardiogram
vectorcardiogram
