室早TpR指数与特发性流出道室早症状的关系  

Relationship between TpR index and symptoms of idiopathic outflow tract premature ventricular contraction

作　　者：张奇[1] 赵春梅[1] 王德国[1] 杨琴[1] 李小荣[2] 张凤祥[2] 曹克将[2] 

机构地区：[1]皖南医学院弋矶山医院老年医学科,安徽芜湖241001 [2]南京医科大学第一附属医院心脏科,江苏南京210029

出　　处：《实用心电学杂志》2016年第4期271-274,277,共5页Journal of Practical Electrocardiology

基　　金：国家"十二五"科技支撑计划项目(2011BAI11B13);国家自然科学基金资助项目(81200142);安徽省自然科学基金资助项目(1208085QH156);弋矶山医院引进人才科研基金资助项目(YR201506)

摘　　要：目的分析流出道室早(premature ventricular contraction,PVC)患者心律失常症状与体表心电图特征的关系及其临床意义。方法将97例流出道室早患者根据有无心律失常症状分成两组:有症状组60例,无症状组37例。患者行心脏超声和体表标准12导联心电图检查,测定患者室早负荷、PVC波宽度、联律间期、PVC联律间期指数(PVC联律间期/窦性RR周期×100%)、室早TpR间期(PVC前窦性T波顶点到PVC起点间时程)、室早TpR指数(早搏TpR间期/窦性TpR间期×100%),分析其与心律失常症状间的关系。结果有症状组PVC联律间期指数、PVC TpR间期及PVC TpR指数显著大于无症状组(P<0.05),而两组间室早负荷、起源及其他心电参数无显著差异。Spearman相关性分析显示PVC症状与PVC联律间期指数呈显著正相关(r=0.324,P<0.05),与PVC TpR间期呈显著正相关(r=0.272,P<0.05)、与PVC TpR指数呈显著正相关(r=0.457,P<0.05)。结论有症状的流出道室早患者PVC联律间期指数和TpR指数大于无症状组,室早症状与PVC延迟出现有关,对室早临床症状的控制有一定意义。Objective To analyze the relationship between arrhythmic symptoms of the patients with outflow tract premature ventricular contraction（ PVC） and characteristics of surface electrocardiogram（ ECG）,and to explore its clinical significance. Methods According to the existence of PVC-related arrhythmic symptoms,97 outflow tract PVC patients were divided into two group：symptomatic group（ 60 cases） and asymptomatic group（ 37 cases）. The examination of echocardiography and standard 12 lead surface ECG were performed on all the patients. The measured parameters included PVC burden,the width of PVC complex,coupling interval,index of PVC coupling interval（ PVC coupling interval ÷ sinus RR cycle × 100%）,TpR interval of PVC（ the duration from sinus T peak before PVC to the starting point of PVC） and TpR index of PVC（ TpR interval of PVC ÷sinus TpR interval × 100%）. The relationship between the above measured parameters and arrhythmic symptoms was analyzed. Results In the symptomatic group,the index of PVC coupling interval,TpR interval of PVC and TpR index of PVC were significantly higher than those in the asymptomatic group（ P〈0. 05）. However,there was no statistically significant difference of PVC burden,origin of PVC or other ECG parameters between the two groups. Spearman correlation analysis showed that PVC-related symptoms were significantly positively correlated with the index of PVC coupling interval（ r = 0. 324,P〈0. 05）,TpR interval of PVC（ r = 0. 272,P〈0. 05） and TpR index of PVC（ r = 0. 457,P〈0. 05）. Conclusion PVC-related symptoms are associated with higher index of PVC coupling interval and TpR index for patients with outflow tract PVC. Those symptoms are related to the delayed emergence of PVC,which is helpful in the control of PVC clinically.

关 键 词：体表心电图 流出道室性早搏 室早负荷 PVC联律间期指数 室早TpR指数 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]