高血压病左室壁增厚50例超声心动图与心电图对比分析(1)
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[摘要] 目的:比较超声心动图和心电图检查的诊断价值。方法:对高血压患者进行超声心动图与心电图对比检查。结果:超声心动图提示左室肥厚、左室肥大、单纯室间隔增厚的患者,其心电图阳性符合率分别为66.7%、77.7%和29.4%。结论:超声心动图对高血压的诊断价值明显优于心电图检查,心肌肥厚形态学改变早于电生理改变,尤其对于单纯室间隔增厚的患者,认为左室后负荷增加首先作用于左室流出道,是室间隔较早肥厚的原因。诊断高血压心脏病必须结合超声心动图检查以求确诊。
[关键词] 高血压;超声心动图;心电图
[中图分类号] R445.1[文献标识码] B [文章编号]1673-7210(2010)06(a)-099-02
Comparative analysis of 50 cases of hypertension with left ventricular hypertrophy on echocardiography and ECG
YUAN Ning
(Department of Ultrasound, the Fourth People's Hospital of Shenyang, Shenyang 110031, China)
[Abstract] Objective: To compare echocardiography and ECG examination of the diagnostic value. Methods: Echocardiography and ECG examination in hypertensive patients were contrasted. Results: Echocardiography indicated left ventricular hypertrophy, left ventricular dilatation, left ventricular hypertrophy in patients with simple septal hypertrophy, the ECG positive consistent rates were 66.7%, 77.7% and 29.4% respectively. Conclusion: Echocardiographic diagnosis of high blood pressure is superior to ECG, morphological changes of cardiac hypertrophy as early electrophysiological changes, especially for simple ventricular septal hypertrophy. The role of increased left ventricular after load on the left ventricular outflow tract is the reason for septal hypertrophy in early. Diagnosis of hypertensive heart disease should combine with echocardiography.
[Key words] Hypertension; Echocardiography; ECG
高血压病是老年人的常见病,发病率较高,高血压状态持续存在时,由于压力负荷的代偿机制产生左室肥厚。临床工作中常常遇到高血压病患者心电图检查提示左心室肥厚或左室高电压,而超声检查正常;或超声提示左室肥厚者而心电图正常。为此,笔者就经超声检查提示左室肥厚的患者,逐一与心电图进行比较分析。
1 资料与方法
1.1 一般资料
本组收集2009年1～9月55例高血压患者,男性30例,女性25例;平均年龄54岁;高血压病史2～20年,合并冠心病15例。
1.2 方法
将高血压并经超声证实左室肥厚的患者逐一做心电图检查,进行比较。超声检查采用日本型ALOKA-a10超声诊断仪,探头频率2.5 MHz,取左室长轴切面、心尖四腔切面及左室短轴切面进行观察,并同时测量其左室间隔及左室后壁厚度、左室腔大小。按照王新房的《超声心动图学》规定,认为室间隔及左室后壁厚度超过9 mm为增厚;左室内径男性大于55 mm、女性大于50 mm为左室扩大。检查结果分单纯室间隔增厚、左室弥漫均匀增厚、左室肥大三种情况,分别与心电图检查进行比较。
2 结果
见表1。
表1 左室增厚超声心动图与心电图检查对比
Tab.1 Comparison of left ventricular hypertrophy
by echocardio graphy and ECG
*:左室肥厚是指室间隔与左室后壁均增厚,而腔室内径大小正常;**:左室肥大是指室间隔与左室后壁均增厚,同时腔室内径亦扩大
*: left ventricular hypertrophy was the interventricular septum and left ventricular posterior wall thickness, but left ventricular internal diameter was in the normal range; **: left ventricular hypertrophy was the interventricular septum and left ventricular posterior wall thickness was the same time, left ventricular internal diameter was also expanded ......
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