慢性心力衰竭患者Tp-e/QT比值变化及其临床意义  

The Tp-e/QT Ratio change in Chronic Heart Failure Patients and Its Clinical Significance

作　　者：卢海燕[1] 施振华[1] 陈礼平[1] 吴雅琴[1] 叶科星[1] 

机构地区：[1]丽水市中心医院,浙江丽水32300

出　　处：《心脑血管病防治》2011年第4期270-271,322,I0002,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：近年来,国内外研究证实心脏室壁心肌具有电异质性,心室肌跨壁复极离散度产生的一个正常存在的电生理现象,并且发现异常增大的跨壁复极离散度是多种室性心律失常（室性心动过速、心室颤动、心源性猝死）发生的主要基质,也是预测室性心律失常的重要指标[1]。T波峰-末间期（Tp-e）已证实可作为反映心室跨壁复极离散度的量化指标[2]。Objective To explore The Tp-e/QT Ratio change in Chronic Heart Failure Patients and Its Clinical Significance.Methods 158 patients with chronic heart failure（CHF group） and 200 healthy adults（control group） were measured within 24 hours of their admission of the first ECG QTd,Tp-e,QTc,and calculate the Tp-e/QT ratio,and analyzed the relationship beween it and the occurrence of the malignant ventricular arrhythmia.Results Compared with the control group,Electrocardiogram in patients with heart failure.The QTd,Tp-e and QTc were significantly prolonged [（35.58±15.86） ms vs.（56. 31±33.18） ms,（88.48±13.17） ms vs（139.36±41.12） ms and（427.58±32.21） ms vs.（485.23±49.63） ms,P0.01],and Tp-e/QT ratio increased significantly（0.21±0.05 vs.0.29±0.09,P0.01）.Among 158 patients with chronic heart failure,there were 34 patients（21.5%） having malignant ventricular arrhythmias,and their ECG,QTd,Tp-e,and QTc were longer than those without malignant ventricular arrhythmias,but the Tp-e/QT ratio increased significantly（0.34±0.03 vs 0.27±0.06,P0.01）.Conclusions Among the chronic heart failure patients,Tp-e/QT ratio is significantly longer than that in healthy adults.Tp-e/QT ratio and the incidence of malignant ventricular arrhythmia are significantly correlated,and they may be the most important early warning indicators for the sudden cardiac death.

关 键 词：慢性心力衰竭患者 临床意义 比值变化 跨壁复极离散度 室性心律失常 T波峰-末间期 室性心动过速 心源性猝死 

分 类 号：R541.6[医药卫生—心血管疾病]