TpTe和TpTe/QT在心脏性猝死一级预防植入埋藏式心脏转复除颤器的预测价值  

The predictive value of TpTe and TpTe/QT in patients with an implantable cardioverter-defibrillator for primary prevention of sudden cardiac death

作　　者：黄启祥[1] 彭宇程[2] 郑悦海[1] 方红[1] 张伟明[3] 

机构地区：[1]广东省江门市中心医院心电生理室,广东江门529000 [2]广东省江门市中心医院心血管内科,广东江门529000 [3]广东省江门市中心医院信息科,广东江门529000

出　　处：《中国心脏起搏与心电生理杂志》2017年第6期511-514,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨TpTe和TpTe/QT在心脏性猝死(SCD)一级预防植入埋藏式心脏转复除颤器(ICD)有效性的预测价值。方法通过回顾性分析符合SCD一级预防并植入ICD患者的TpTe、TpTe/QT无创检测指标,并通过起搏器程控仪调取起搏器数据,根据是否发生正确心血管事件(室性心动过速或心室颤动)及适当的ICD治疗分两组,对比分析指标在两组间的统计差异程度。结果两组间TpTe间期和TpTe/QT有显著差异[(96.82±12.11)ms vs(76.77±11.25)ms;0.24±0.02vs 0.20±0.02,P均<0.001]。TpTe和TpTe/QT的ROC曲线显示曲线下面积分别为0.897 8(95%CI 0.821~0.975)、0.898 2(95%CI 0.828~0.968。ROC曲线对应的值TpTe间期≥97ms,灵敏度为55%,特异度100%(95%CI 0.821~0.975),TpTe/QT≥0.23,灵敏度为70%,特异度91.1%(95%CI 0.828~0.968)。结论 TpTe和TpTe/QT在预测SCD一级预防植入ICD的有效性有较高的临床应用价值。Objective To explore the predictive value of TpTe and TpTe/QT on the effectiveness of implantable cardioverter-defibrillator（ICD）for primary prevention of sudden cardiac death（SCD）. Methods This research analysed the noninvasive detection index（TpTe and TpTe/QT）in patients with implanted ICD for primary prevention of SCD through the retrospective analysis.The follow-up data was divided into two groups according to whether the correct cardiovascular events occurred（ventricular tachycardia or ventricular fibrillation）and the appropriate ICD therapy was done.And the difference of indicators and optimal combination between the two groups were analysed.Results There were significant differences between TpTe and TpTe/QT[（96.82±12.11）ms vs（76.77±11.25）ms;0.24±0.02 vs 0.20±0.02,all P0.001].The areas under the ROC curve of TpTe and TpTe/QT were 0.897 8（95% CI 0.821 to 0.975）and 0.8982（95% CI 0.828 to 0.968）.TpTe interval≥97 ms,the sensitivity and specificity were 55% and 100%,respectively.TpTe/QT≥0.23,the sensitivity and specificity were 70% and 91.1%respectively. Conclusions This study results show there is high predictive value of TpTe and TpTe/QT on the effectiveness of implanted ICD for primary prevention of SCD.

关 键 词：心血管病学 心脏性猝死 一级预防 TpTe间期 TpTe/QT 

分 类 号：R541.78[医药卫生—心血管疾病] R318.11[医药卫生—内科学]