| 叶如,陈玲,张丽娜.下壁导联CrochetageR波联合左房容积指数对卵圆孔未闭诊断价值评价[J].浙江中西医结合杂志,2024,34(5): |
| 下壁导联CrochetageR波联合左房容积指数对卵圆孔未闭诊断价值评价 |
| The diagnostic value of Crochetage R wave in inferior leads of ECG and left atrial volume index in patients with patent foramen ovale |
| 投稿时间：2023-09-05 修订日期：2023-12-18 |
| DOI： |
| 中文关键词: 卵圆孔未闭 CrochetageR波 左房容积指数 右心声学造影检查 诊断价值 |
| 英文关键词:patent foramen ovale, Crochetage R wave, left atrial volume index, Right cardiac acoustic imaging, diagnostic value |
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| 中文摘要: |
| 目的：分析心电图下壁导联特异性CrochetageR波与心脏超声检测的左房容积指数(LAVI)对卵圆孔未闭(PFO)患者的诊断价值。方法：选择40例本院住院治疗的PFO患者为观察组,同期40例健康体检者为对照组。两组均予以心电图、经胸超声心动图以及右心声学造影检查(cTTE)。比较两组下壁导联CrochetageR波发生率以及心脏超声检查指标的差异。以cTTE为金标准,分析下壁导联CrochetageR波联合LAVI对PFO诊断准确性。绘制受试者工作特征曲线(ROC),评估下壁导联CrochetageR波联合LAVI对PFO患者的诊断价值。结果：与对照组相比,观察组患者下壁单导联、双导联、三导联出现CrochetageR波发生率显著较高(均P<0.05),左房内径以及LAVI也明显增加(均P<0.05)。以cTTE为金标准,下壁导联出现CrochetageR波的导联数越多,诊断价值越高；下壁导联CrochetageR波与LAVI联合诊断价值较单指标更高,而下壁三导联CrochetageR波与LAVI联合的诊断价值最高,敏感性为87.5%,特异性为92.5%,阳性预测值为92.11%,阴性预测值为88.10%。ROC曲线显示,下壁三导联CrochetageR波联合LAVI>50.50ml/m2,诊断PFO患者的AUC为0.849,敏感度为87.5%,特异度为92.5%。结论：心电图下壁导联特异性CrochetageR波与LAVI能有效诊断PFO,值得临床推广。 |
| 英文摘要: |
| Objective To analyze the diagnostic value of Crochetage R wave in inferior leads of ECG and left atrial volume index (LAVI) in patients with patent foramen ovale (PFO). Methods The 40 patients with PFO in our hospital were collected as observation group. And the 40 healthy examinees that were diagnosed without PFO during the same period were collected as the control group. All subjects were accepted by ECG, transthoracic echocardiography (TTE) and contrast transthoracic echocardiography (cTTE). The difference of the occurrences of Crochetage R wave at lower wall leads and indexes of TTE were compared between two groups. Regarding the cTTE to goldern standard, the values of the Crochetage R wave at lower wall leads combined to LAVI to the PFO were analyzed. The diagnostic value of the Crochetage R wave at lower wall leads combined to LAVI to the diagnosis of the patients with PFO were analyzed by receiver operating characteristic curves (ROC). Results Compared to control group, the occurrences of Crochetage wave in single lead, two leads, three leads in observation group were higher respectively (all P<0.05), and the left atrial diameter and LAVI in observation group were higher (all P<0.05). The more leads appeared the Crochetage wave R wave at lower wall; the higher diagnostic value was get. The diagnostic value of Crochetage R wave at lower wall leads combined to LAVI was higher than single index, and the Crochetage R wave at 3 leads combined to LAVI was highest, which was sensitivity at 87.5%, specificity at 92.5%, positive predictive value at 92.11%, negative predictive value at 88.10%. When the cut-off point of the LAVI was 50.50ml/m2, the AUC of diagnosis to patients with PFO was 0.849 and the sensitivity was 87.5% and specificity was 92.5%. Conclusion The Crochetage R wave at 3 leads combined to LAVI can diagnosis the patients with PFO. |
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