体表心电图指标对扩张型心肌病伴发心力衰竭患者整体心室复极离散变化的评价  

Evaluation of global dispersion of ventricular repolarization in dilated cardiomyopathy patients with heart failure by the characteristic of electrocardiogram

作　　者：丛培欣[1] 李世军[2] 张燕[1] 夏云龙[1] 尹晓盟[1] 张树龙[1] 高连君[1] 杨延宗[1] 

机构地区：[1]大连医科大学附属第一医院心血管病医院,116011 [2]大连市中心医院心内科

出　　处：《中国医师进修杂志》2012年第10期10-12,共3页Chinese Journal of Postgraduates of Medicine

基　　金：基金项目：国家自然科学基金青年类（30800378）

摘　　要：目的分析扩张型心肌病伴发心力衰竭患者T波峰．末间期（Tpe）的特点及其在评价整体心室复极离散中的意义。方法选择扩张型心肌病伴发心力衰竭患者28例（心力衰竭组）及无器质性心脏病且心功能正常的室上性心动过速患者25例（对照组），分别测量体表心电图12个导联的Tpe和QT间期，计算QT间期离散度（QTd）、Tpe平均值校正值（TpeAVEC）、Tpe最大值校正值（Tpe-MWXC），并进行比较。结果心力衰竭组Tpe．AWC、TpeMAXC、QTd显著高于对照组[（106．31±26．34）ms比（82．724-10．01）ms，（234．05±69．75）ms比（119．15±11．55）ms，（119．17±67．62）ms比（39．74±17．04）ms]，差异均有统计学意义（P〈0．05或〈0．01）。结论扩张型心肌病伴发心力衰竭患者整体心室复极离散明显增加。Tpe．AVEC及Tpe.MAXC可作为扩张型心肌病伴发心力衰竭患者心室复极离散的无创性评价指标。Objective To analyze the characteristic of the T peak-end interval （Tpe） in dilated cardiomyopathy （DCM） patients with heart failure and its significance in evaluation of global dispersion of ventricular repolarization. Methods Fifty-three inpatients were enrolled in this study,which included 28 patients with DCM and heart failure （DCM group）, and 25 patients with supraventricular tachycardia and without structural heart disease （control group）. The Tpe and the dispersion of QT interval （QTd） from the 12-lead surface electrocardiogram （ECG） were acquired and measured, and consequently the corrected numerals of the average of Tpe （Tpe.swc）, the maximal Tpe （Tpe_MAXC） were acquired. Results The levels of Tpe.AVEC, Tpe.MAXC and QTd in DCM group were significantly higher than those in control group [ （ 106.31± 26.34） ms vs. （82.72 ± 10.01 ） ms, （234.05 ± 69.75） ms vs. （ 119.15± 11.55） ms, （ 119.17 ±67.62） ms vs. （39.74± 17.04） ms]（P〈 0.05 or 〈 0.01 ）. Conclusions The global dispersion of ventricular repolarization is significantly increased in patients with DCM and heart failure. The Tpe.AVEC and Tpe.MAXC are recommended to be used for evaluating the dispersion of ventricular repolarization as the prognostic index in patients with DCM and heart failure.

关 键 词：心肌病 扩张型 心力衰竭 充血性 T波峰-末间期 QT间期 心室复极离散度 

分 类 号：R541.7[医药卫生—心血管疾病] R542.2[医药卫生—内科学]