Tp-ec、Tp-e/QT对急性ST段抬高性心肌梗死恶性心电生理事件的预测价值  

Predictive value of Tp-ec and Tp-e/QT on occurrence of malignant cardiac electrophysiological events in patients with acute ST segment elevation myocardial infarction

作　　者：肖国胜[1] 王宪沛[2] 高传玉[2] 王焱[1] 刘静静[2] 

机构地区：[1]厦门大学附属中山医院心脏中心,厦门361004 [2]河南省人民医院心内科河南省心血管流行病学研究所

出　　处：《临床心血管病杂志》2012年第7期501-504,共4页Journal of Clinical Cardiology

摘　　要：目的:观察急性ST段抬高性心肌梗死(STEMI)患者QT间期、Tp-ec(校正的T波的顶点到T波的终点的时间)和Tp-e/QT指标的变化及这些指标与恶性心电生理事件的相关性。方法:急性STEMI患者60例,测量并计算梗死相关和非梗死导联QT、QTc、Tp-ec、Tp-e/QT比值,记录1年内恶性心电生理事件。正常心电图60例作为对照。结果:①急性STEMI 12h内梗死和非梗死导联QTc明显延长(P<0.01),1周和1个月回复正常水平。梗死相关导联12h内Tp-ec间期比非梗死导联及对照组均明显延长(均P<0.01),1周和1个月逐渐回复正常。Tp-e/QT比值在梗死相关导联比其他导联明显增大(P<0.01),随之逐渐回复,但仍与对照组差异有统计学意义(P<0.01)。②QTc 440ms作为截点电生理事件发生差异无统计学意义(P>0.05),而分别以Tp-ec100ms和Tp-e/QT比值0.25作为截点恶性电生理事件发生差异有统计学意义(P<0.05)。结论:在心肌梗死急性期Tp-ec,尤其是Tp-e/QT比值增加,与恶性电生理事件相关,是预测急性STEMI后恶性电生理事件的指标。To predict the value of Tp-ec （corrected Tp-e） and Tp-e/QT on occurrence of malignant cardiac electrophysiological events （MCEE） in acute ST segment elevation myocardial infarction （STEMI） patients. Method：Different indices of QT, QTe, Tp-ec, Tp-e/QT were measured and calculated in infarction-related ECG lead and non-infarction-related lead, respectively, in clinical definited 60 cases of STEMI patients. McEE were recorded in one year. Sixty cases of normal patients ECG were aollected as control group. Result： ①QTc of infarc-tion-related lead and non-infarction-related lead were prolonged significantly in 12 hours after acute STEMI （P〈 0.01）, and then returned to normal level in one week and one month, respectively （P〈0.0l）. Comparing （QTc, QT Tp-ec, Tp-e/QT） in non-infarction-related lead and control, Tp-ee intervals in infarction-related lead were prolonged significantly, and recovered gradually （P〈0.01） to the level which was no difference with that of con-trol in one week and one month （P〉0.05）. While Tp-e/QT ratio in infarction-related lead increased significantly compared with those in other group, then recovered, the recovered value still had significant difference with that in control （P 〈 0.05）. ② The occurrence of MCEE had no difference between QTc joint points as 440 ms （P〉0.05）. And the occurrence of MCEE had significant difference （P〈0.05） when joint point of Tp-ec as 100 ms and that of Tp-e/QT ratio as 0.25, respectively. Conclusion： In the acute phase of myocardial infarction, the increase of Tp-ec, and specially Tp-e/QT ratio are correlated with occurrence of MCEE. Tp-ec and Tp-e/QT are indicators to predict MCEE in acute STEMI patients.

关 键 词：心肌梗死 TP-E间期 Tp-e/QT比值 跨室壁离散 恶性电生理事件 

分 类 号：R542.2[医药卫生—心血管疾病]