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目的分析肥厚型心肌病患者的心电学特征和常规肥厚指标,并拟选取新指标观察其敏感性和特异性,与常规指标的关联性及优越性。方法肥厚型心肌病(HCM)组105例与正常对照组65例,予以常规12导联心电图及超声心动图检查。结果 HCM组的心电常规参数,临床异常特征比例及肥厚指标均比正常对照组高(p<0.01);方差分析:复极化异常中亚组之间均有明显差异;新指标RV3+SV1无梗阻性与梗阻性,心尖肥厚型均有统计学差异(p=0.017;p=0.038);ROC分析:当RV2+SV1取值2.0mV,敏感度56.2%,特异度90.8%,阳性预测值89.5%,阴性预测值56.3%;RV3+SV1取值2.48mV,敏感度57.1%,特异度92.3%,阳性预测值92.18%,阴性预测值56.19%。结论肥厚型心肌病较常人更易发生复极化异常和除极化异常,RV3/RV2+SV1优于所有传统肥厚指标,可作为一项较为特异性的诊断指标。
Objective To analyze the characteristics of electrocardiogram (ECG) and conventional hypertrophy in patients with hypertrophic cardiomyopathy, and to select the new index to observe the sensitivity and specificity, and the correlation and superiority with conventional indicators. Methods 105 patients with hypertrophic cardiomyopathy (HCM) and 65 normal controls were enrolled in the routine 12-lead ECG and echocardiography. Results The parameters of ECG, the proportion of abnormal clinical features and the indexes of hypertrophy in HCM group were higher than those in normal control group (p <0.01). Analysis of variance (ANOVA) ROC analysis: when RV2 + SV1 value of 2.0mV, the sensitivity of 56.2%, specificity of 90.8%, positive predictive value (p = 0.017; p = 0.038) 89.5% and negative predictive value of 56.3%. RV3 + SV1 was 2.48mV, sensitivity was 57.1%, specificity was 92.3%, positive predictive value was 92.18%, negative predictive value was 56.19%. Conclusions Hypertrophic cardiomyopathy is more likely to have repolarization and depolarization abnormalities than normal people. RV3 / RV2 + SV1 is superior to all traditional hypertrophy markers and may be used as a more specific diagnostic indicator.