健康人心室复极震荡的不同指标测量方法及影响因素的研究  

Various parameters and influential factors for measurement of ventricular repolarization turbulence in healthy individuals

作　　者：王红宇[1] 曾秋棠[2] 

机构地区：[1]山西医科大学第二医院远程心电监护中心,太原030001 [2]华中科技大学同济医学院协和医院心内科

出　　处：《中国药物与临床》2010年第1期32-35,共4页Chinese Remedies & Clinics

基　　金：山西省卫生厅科技攻关计划项目(200504)

摘　　要：目的探讨心室复极震荡(VRT)不同指标的测量方法及影响因素,明确健康成人VRT的变化规律。方法选择接受12导联24h动态心电图(Holter)检查并记录有室性期前收缩(PVC)的健康体检者300名,每名分别测定并比较同步Ⅱ导联、V5导联中,不同心率、不同形态PVC前后的JTp间期、Tpe间期和T波振幅,计算各个指标VRT的震荡初始(VRTO),包括:JTp震荡初始(JTpTO)、Tpe震荡初始(TpeTO)和T波振幅震荡初始(TwaTO),分析其与心率和各个间期的相关性。结果①震荡前、后同步Ⅱ导联、V5导联比较JTp间期、Tpe间期和T波振幅,除JTp4间期外,所有数据的差异具有统计学意义(P<0.01)。同一导联震荡后每一个心搏JTp间期、Tpe间期和T波振幅与震荡前比较多数差异有统计学意义(P<0.01)。②Ⅱ导联JTpTO和第二心搏震荡、TwaTO与第一心搏震荡变化方向相反。③健康人JTp各个震荡参数与室性期前收缩前基础心率呈负相关(P<0.01),Tpe、Twa各个震荡参数与室性期前收缩前基础心率不相关(P>0.05),多数指标与联律间期和代偿间期相关。结论健康人存在VRT现象,不同组群之间进行VRT比较时要采用同一导联测定的数据,同时应考虑到室性期前收缩前基础心率、代偿间期、联律间期的影响。Objective To investigate the various approaches and influential factors for measurement of ventrieular repolarization turbulence （VRT） and to clarify the variation of VRT in healthy individuals. Methods Three hundred healthy individuals were enrolled in whom 12-lead 24 hours ambulatory electrocardiograph （AECG） was performed and ventricular premature complexes （PVC） identified. In Ⅱ and V5 leads, we measured JTp periods, Tpe periods and T wave amplitudes before and after PVC at different heart rates and with various shapes. These data were collected and processed to obtain the values of every turbulence onset of VRT： JTp turbulence onset （JTpTO）, Tpe turbulence onset （TpeTO） and T wave amplitude turbulence onset （TwaTO）. Correlation analysis was perform between VRT and heart rate （HR）, coupling interval and compensatory interval. Results ①Therc were statistically significant differences in JTp periods, Tpc periods and T wave amplitudes between Ⅱ leads and V s before and after PVC except for JTp4 （P〈0.01）.② In Ⅱ lead, opposite direction of change were showed between JTpTO and JTpTO2, and between TwaTO and TwaTO1. ③There was a negative correlation between JTp and HR （P〈0.01） and no correlation between Tpe, Twa and HR（P〉0.05） in healthy individuals. Most VRT indexes were correlated with the coupling and compensatory intervals （P〈0.05）. Conclusion VRT can be present in normal subjects. Comparison between different cases should be based on data measured from the same lead. hnpacts of coupling interval, compensatory interval and baseline HR on the measurement should be recognized.

关 键 词：心室复极震荡 震荡初始 振幅震荡 动态心电图 

分 类 号：R541.7[医药卫生—心血管疾病]