摘要目的 分析12导联心电图用于鉴别诊断肥厚型心肌病与高血压左心室肥厚的临床价值.方法 将2017年1月至2018年6月本院收治的48例肥厚型心肌病患者作为A组,50例高血压左心室肥厚患者作为B组.所有患者进行12导联心电图检查,比较两组的心电图指标(Tp-e间期指标,心电图离散程度,Q波异常、T波倒置及ST-T段压低发生情况),分析12导联心电图指标对肥厚型心肌病的诊断价值.结果 A组Ⅱ、aVR、aVF、V6导联的Tp-e间期均明显大于B组(P<0.05);A组的QTmax、QTmin、QTd均明显大于B组(P<0.05).A组Q波异常的发生率为39.58％(19/48),B组Q波异常的发生率为14.00％(7/50),两组比较差异有统计学意义(P<0.05);Ⅱ导联的Tp-e间期≥64 ms、V6导联的Tp-e间期≥69 ms、Q波异常对肥厚型心肌病的敏感度及特异性分别为77.83％、77.42％,70.44％、81.69％,74.50％、95.42％.结论 12导联心电图能够用于鉴别肥厚型心肌病与高血压左心室肥厚,Ⅱ导联Tp-e间期≥64 ms、V6导联Tp-e间期≥69 ms或Q波异常对肥厚型心肌病具有较高的诊断价值.

abstractsObjective To analyze the clinical value of 12-leads electrocardiogram in the differential diagnosis of patients with hypertrophic cardiomyopathy and hypertensive left ventricular hypertrophy. Methods 48 patients with hypertrophic cardiomyopathy was taken was group A and 50 patients with hypertensive left ventricular hypertrophy was taken was group B in our hospital during January 2017 and June 2018. All the patients were detected by 12-leads electrocardiogram, the electrocardiogram indexes (Tp-e interval indicator, electrocardiogram dispersion degree, occurrence of abnormal Q wave, inverted T wave, and ST-segment depression) were compared between the two groups. The diagnostic value of 12-leads electrocardiogram on hypertrophic cardiomyopathy was analyzed. Results The Tp-e interval of Ⅱ , aVR, aVF, V6 leads of group A were significantly greater than those of group B (P<0.05); the QTmax, QTmin, QTd of group A were significantly greater than those of group B (P<0.05). The occurrence rate of abnormal Q wave was 39.58％ (19/48) in group A, and 14.00％ (7/50) in group B, with statistically significant difference between the two groups (P<0.05). The sensitivity and specificity of Ⅱ lead Tp-e interval ≥64 ms, V6 lead Tp-e interval ≥69 ms, and abnormal Q wave on hypertrophic cardiomyopathy was 77.83％, 77.42％, 70.44％, 81.69％, 74.50％, 95.42％. Conclusion The 12-leads electrocardiogram could be used to identify patients with hypertrophic cardiomyopathy and hypertensive left ventricle hypertrophy, Ⅱ lead Tp-e interval ≥64 ms, V6 lead Tp-e interval ≥69 ms, and abnormal Q wave have high diagnostic value on hypertrophic cardiomyopathy.