天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (9): 843-847.doi: 10.11958/20200057

• 临床研究 • 上一篇    下一篇

改良的Cornell电压对高血压左心室肥厚的诊断价值

缪羽霞1，徐敏1△，朱韵2，王幸2，江姝1，葛志祥1   

  1. 1常州市第一人民医院超声心动图室（邮编213004），2心电图室
  • 收稿日期:2020-01-07 修回日期:2020-06-12 出版日期:2020-09-15 发布日期:2020-09-22
  • 通讯作者: 徐敏 E-mail:loisicelin@163.com
  • 基金资助:
    国家自然科学青年基金项目（81701734）；常州市科技局应用基础研究（CJ20190086）；常州市卫计委指导项目（WZ201804）

The diagnostic value of improved Cornell voltage for hypertensive left ventricular hypertrophy

MIAO Yu-xia1, XU Min1△, ZHU Yun2, WANG Xing2, JIANG Shu1, GE Zhi-xiang1   

  1. 1Department of Echocardiography, 2 Department of Electrocardiogram Laboratory, Changzhou First People's Hospital, Changzhou 213004, China
  • Received:2020-01-07 Revised:2020-06-12 Published:2020-09-15 Online:2020-09-22

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摘要： 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。

关键词: 高血压；肥大, 左心室；心电描记术；超声心动描记术；左心室肥厚；改良的Cornell电压

Abstract: Abstract: Objective　To explore the diagnostic value of improved Cornell voltage in hypertensive patients with left ventricular hypertrophy (LVH). Methods　Data of 381 patients (male 233, female 148) with hypertension were retrospectively 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 aVL lead), SD (maximum S-wave or QS amplitude in 12 leads), Cornell voltage (sum of the amplitude of S wave of V3 lead and R wave of aVL 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 mass index (LVMI) measured by echocardiography was used as the gold standard for diagnosis of LVH. Patients were divided into no-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 indexes for LVH was also compared between the two groups. Results Compared with the no-LVH group, the improved Cornell voltage, SD, Cornell voltage and Sokolow-Lyon voltage were significantly higher in the LVH group (P＜0.01). In male patients with hypertension, the AUC, cut-off value, sensitivity, and specificity of improved Cornell voltage for the diagnosis of hypertension with LVH were 0.810, 1.60 mV, 86.67% and 67.83%, respectively. The diagnostic efficacy of improved Cornell 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 for diagnosis of hypertension with LVH were 0.737, 1.45 mV, 70.51% and 68.57%, respectively. The diagnostic efficacy of improved 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 pressure were independent risk factors of LVH(P＜0.01). Conclusion　The diagnostic value of improved Cornell voltage is better than Cornell voltage and Sokolow-Lyon voltage in hypertensive patients with left ventricular hypertrophy.

Key words: hypertension, hypertrophy,left ventricular, electrocardiography, echocardiography, left ventricular hypertrophy, improved Cornell voltage

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