微伏级T波电交替对肥厚型心肌病高危人群的预测价值  

Prognostic Value of Microvolt T-wave Alternations in Patients with Hypertrophic Cardiomyopathy

作　　者：叶明[1] 姜庆军[1] 葛世俊[1] 方燕[1] 刘艳芳[1] 俞丹[1] 

机构地区：[1]宁波市医疗中心李惠利医院心电图室心内科,315040

出　　处：《心电与循环》2013年第6期478-480,共3页Journal of Electrocardiology and Circulation

基　　金：宁波市社会发展基金(2009C50015)

摘　　要：目的探讨动态心电图分析系统时域法检测微伏级T波电交替(MTWA)对肥厚型心肌病患者恶性室性心律失常及心脏性猝死的预测价值。方法 94例肥厚型心肌病患者(观察组)和105例健康人(对照组)接受24 h动态心电图检查并作MTWA检测。分析两年的死亡、晕厥及恶性心律失常的发生情况。结果对照组MTWA 95%正常值参考范围<36μV。对照组MTWA>36μV的占1 0.5%,观察组MTWA>36μV的占55.3%。对照组无心血管事件发生;观察组发生恶性心律失常29例,MTWA>36μV对恶性心律失常诊断的敏感性79.3%,特异性55.4%;阳性预测值44_2%,阴性预测值85.7%。结论 MTWA异常的肥厚型心肌病患者发生恶性室性心律失常及心脏性猝死的危险性增加。Objective To explore the value of microvolt T-wave alternations （MTWA） in predicting malignant ventricu- lar arrhythmia （VA） and sudden cardiac death （SCD） in patients with hypertrophic cardiomyopathy （HCM）. Methods 24-hour dynamic ECG was recorded and MTWA was tested in 105 healthy subjects （control group） and 97 patients with HCM （HCM group）. Death, syncope and malignant arrhythmia were analyzed during follow-up 2 years. Results The upper limit of 95% confidence interval of MTWA was〈36 IJ V in control group. The number of patients with MTWA 〉36 IJ V was 10.5% in control group and 55.3% in HCM group. 29 cases had malignant VA in HCM group and no one had cardio- vascular events in control group. The sensitivity, specificity, positive predictive value and negative predictive value of MT- WA 〉36 μV in diagnosis of malignant VA were 79.3%, 55.4%, 44.2% and 85.7%, respectively. Conclusion The risk of malignant VA and sudden cardiac death increases in HCM patients with abnormal MTWA.

关 键 词：肥厚型心肌病 T波电交替 室性心律失常 心脏性猝死 

分 类 号：R542.2[医药卫生—心血管疾病]