目的 探讨诊断左前分支阻滞合并左心室肥厚( LAFB+ LVH)的心电图诊断指标.方法 对心电图示左前分支阻滞患者依据超声心动图诊断分为LAFB+ LVH为观察组(n=58)与单纯完全性左前分支阻滞(LAFB)对照组(n=50),并选择电轴左偏(LAD)的正常体检者为正常组(n=50).分析心电图各项左心室肥大指标及SⅢ+胸导最大(R+S)振幅≥3.0My标准的敏感性、特异性及准确性.结果 观察组SⅢ+胸导m.(R+S)均值明显高于对照组,其敏感性、特异性及准确性分别为91.37％、92.00％和91.67％.而其他电压指标的均值均低于诊断LVH的老指标.观察组QRS时限≥0.11s的敏感性70.69％.特异性100％.结论 LAFB时,SⅢ+胸导最大(R+S)振幅≥3.0 Mv标准结合QRS时限≥0.11 s指标可提高心电图对左室肥大诊断的准确率.%Objective To evaluation on the diagnostic value of left anterior fascicular block (LAFB) with left ventricular hypertrophy ( LVH) by EKG. Methods The patients were divided into LAFB + LVH group ( n = 58) , LAFB group(n =50)and normal group(n =50)on UCG. P wave,QRS complex interval,QRS axis,amplitude of R I , SⅢ ,RaVL,RV5(6) ,RV5(6) + SV1 were measured,and SⅢ + (precordial R + S) max,those indexes with that in these groups were compared. Results The average value of S Ⅲ + (precordial R + S) max in LAFB + LVH group was higher than that in LAFB group and normal group, its sensitivity, specificity and accuracy of those indexes were 92. 37% ,92. 00% and 91.67% ,respectively. The specificity of QRS time in LAFB + LVH≥0.11S was 100%. Conclusion Those are effective parameters for the diagnosis of left ventricular hypertrophy in the presence of left anterior hemiblock.
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