T波复杂性比率对急性非ST段抬高型心肌梗死的诊断价值  

Ventricular repolarization dispersion for detection of non-ST elevation myocardial infarction

作　　者：李群[1] 王德昭[1] 林涛[1] 魏欣[1] 陈步星[1] Li Qun Wang Dezhao Lin Tao Wei Xin Chen Buxing(Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京天坛医院心内科,100050

出　　处：《北京医学》2017年第3期261-265,共5页Beijing Medical Journal

摘　　要：目的探讨T波复杂性比率在急性非ST段抬高型心肌梗死(NSTEMI)患者中的诊断价值。方法回顾性分析436例急性冠脉综合征患者的临床资料,所有患者入院后立即行12导联Holter检查,通过对12导联心电图做主成分分析并计算T波复杂性比率。临床结果通过病历记录获得。采用多因素回归分析对NSTEMI和住院期间主要不良心血管事件(MACE)的影响因素进行分析。结果 T波复杂性比率升高是NSTEMI(OR=2.248,95%CI 1.549~3.263,P<0.001)和住院期间MACE(OR=3.037,95%CI 1.886~4.890,P<0.001)的预测因子,进行ROC分析,AUC分别为0.715和0.770。结论测量体表12导联心电图的总体T波复杂性比率可以发现和定量NSTEMI患者非局限性的心肌损伤,并给早期冠心病胸痛患者的评估带来了潜在获益。Objective To explore the relationship between T-wave complexity ratio and non-ST-segment elevation myocardial infarction（NSTEMI）. Methods A total of 436 patients with acute coronary syndrome（ACS） were retrospectively analyzed. All the patients admitted to hospital after immediate detection of 12-lead Holter ECGs. T-wave complexity ratio was quantified using principal component analysis of the 12-lead ECG. Clinical outcomes were obtained from hospital records. Results An increased T-wave complexity ratio on the presenting ECG was associated with NSTEMI（OR=2.248,95%CI 1.549-3.263, P 〈0.001） and in-hospital MACE（OR=3.037,95%CI 1.886-4.890, P 〈0.001）. The receiver-operating characteristic curve （ROC） analysis for T-wave complexity ratio in predicting NSTEMI and MACE showed area under the curve was 0.715 and 0.770. Conclusions T-wave complexity ratio on the presenting 12-lead ECG correlates with myocardial injury and can discriminate NSTEMI cases very early during evaluation.

关 键 词：心室复极离散度 非ST段抬高型心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]