实用心电学杂志
實用心電學雜誌
실용심전학잡지
JOURNAL OF PRACTICAL ELECTROCARDIOLOGY JS
2009年
3期
174-176
,共3页
室性心动过速%Brugada标准%Steurer标准%Verecke标准%心电图单项标准
室性心動過速%Brugada標準%Steurer標準%Verecke標準%心電圖單項標準
실성심동과속%Brugada표준%Steurer표준%Verecke표준%심전도단항표준
ventricular tachycardia Brugada criterion Steurer criterion Verecke criterion sigle criterion
目的 评价Brugada标准、Steurer标准、Verecke标准以及这3种标准中各个单项标准对诊断室性心动过速(VT)的价值及其存在的缺陷.方法 对120例VT者发作时常规12导联同步心电图进行分析.计算以上各种标准对诊断VT的敏感性以及上述3种标准对各种器质性心脏病所致的VT及无器质性心脏病的特发性VT(IVT)的敏感性.结果 3种标准中的各个单项标准对诊断VT的敏感性较低,均小于60%;而多项组合上述3种标准对诊断VT的敏感性明显提高,依次分别为:96.7%、74.2%及86.7%.另外,3种标准对器质性心脏病所致VT的敏感性较高,分别为99.1%、81.3%及96.7%,而Brugada标准对右束支传导阻滞(RBBB)型的IVT的敏感性较高(100%),对左束支传导阻滞(LBBB)型的IVT的敏感性较低(40%),而Steurer标准及Verecke标准对IVT的敏感性均较低(0%～12.5%).结论 心电图单项标准对诊断VT敏感性较低,不能依据心电图某单一标准来诊断VT.多项组合的Brugada标准是诊断VT最敏感的方法,但对LBBB型的IVT敏感性较低.诊断时应密切结合临床资料以及其它诊断标准综合考虑.
目的 評價Brugada標準、Steurer標準、Verecke標準以及這3種標準中各箇單項標準對診斷室性心動過速(VT)的價值及其存在的缺陷.方法 對120例VT者髮作時常規12導聯同步心電圖進行分析.計算以上各種標準對診斷VT的敏感性以及上述3種標準對各種器質性心髒病所緻的VT及無器質性心髒病的特髮性VT(IVT)的敏感性.結果 3種標準中的各箇單項標準對診斷VT的敏感性較低,均小于60%;而多項組閤上述3種標準對診斷VT的敏感性明顯提高,依次分彆為:96.7%、74.2%及86.7%.另外,3種標準對器質性心髒病所緻VT的敏感性較高,分彆為99.1%、81.3%及96.7%,而Brugada標準對右束支傳導阻滯(RBBB)型的IVT的敏感性較高(100%),對左束支傳導阻滯(LBBB)型的IVT的敏感性較低(40%),而Steurer標準及Verecke標準對IVT的敏感性均較低(0%～12.5%).結論 心電圖單項標準對診斷VT敏感性較低,不能依據心電圖某單一標準來診斷VT.多項組閤的Brugada標準是診斷VT最敏感的方法,但對LBBB型的IVT敏感性較低.診斷時應密切結閤臨床資料以及其它診斷標準綜閤攷慮.
목적 평개Brugada표준、Steurer표준、Verecke표준이급저3충표준중각개단항표준대진단실성심동과속(VT)적개치급기존재적결함.방법 대120례VT자발작시상규12도련동보심전도진행분석.계산이상각충표준대진단VT적민감성이급상술3충표준대각충기질성심장병소치적VT급무기질성심장병적특발성VT(IVT)적민감성.결과 3충표준중적각개단항표준대진단VT적민감성교저,균소우60%;이다항조합상술3충표준대진단VT적민감성명현제고,의차분별위:96.7%、74.2%급86.7%.령외,3충표준대기질성심장병소치VT적민감성교고,분별위99.1%、81.3%급96.7%,이Brugada표준대우속지전도조체(RBBB)형적IVT적민감성교고(100%),대좌속지전도조체(LBBB)형적IVT적민감성교저(40%),이Steurer표준급Verecke표준대IVT적민감성균교저(0%～12.5%).결론 심전도단항표준대진단VT민감성교저,불능의거심전도모단일표준래진단VT.다항조합적Brugada표준시진단VT최민감적방법,단대LBBB형적IVT민감성교저.진단시응밀절결합림상자료이급기타진단표준종합고필.
Objective To assess three diagnostic criteria, namely Brugada criterion, Steurer criterion and Verecke criterion and to evaluate the value and defects of these three criteria for ventricular tachycardia (VT). Methods we an-alysed 12 lead EKG of 120 cases of VT patients during the period of onset. Calculation was done for the sensitiveness of di-agnosing VT, organic heart disease associated VT and idiopathic VT(IVT) using the criteria of Brugada, Steurer and Ve-recke. Results Every single component of the three criteria for VT diagnosis showed low sensitiveness, all smaller than 60%. Whereas there was a significant increase in the sensitiveness of the multi-step Brugada criterion, Steurer criterion and Verecke criterion for VT (96.7%, 74.2% and 86.7%, respectively). In addition, the three criteria for organic heart disease associated VT showed comparatively higher sensitiveness (99.1%, 81.3% and 96.7%, respectively). Brugada criterion had higher sensitiveness (100%) for the diagnosis of RBBB type of IVT and lower one (40%) for LBBB type of IVT. Both Steurer and Verecke criteria showed lower sensitiveness in the diagnosis of IVT(0%～12.5%). Conclusion The single component of ECG criteria had lower sensitiveness of the dianosis of VT. it cannot diagnose VT with sigle cri-teria. And the multi-step Brugada criterion was considered as one of the most sensitive methods to diagnose VT, but showed lower sensitiveness in diagnosing LBBB type of IVT. Thus, the clinical data and other diagnostic criteria should be comprehensively taken into consideration so as to avoid misdiagnosis.
