心肌复极异常心电图对冠心病心衰的诊断价值和预后的关系  

Relationship between Myocardial Repolarization Electrocardiogram and the Prognosis of Coronary Heart Disease with Heart Failure

作　　者：郭长苟 Guo Changgou(Department of Geriatrics, the People＇ s Hospital of Jinfeng, Zhangjiagang 215625, Chin)

机构地区：[1]江苏省张家港市锦丰人民医院老年科

出　　处：《国际老年医学杂志》2018年第2期70-72,共3页International Journal of Geriatrics

摘　　要：目的探讨心肌复极异常心电图对冠心病心衰的诊断价值和预后的关系。方法2014年10月～2016年10月于我院进行诊治的冠心病心力衰竭患者98例，根据预后状况将98例冠心病心衰患者分为预后良好组、预后不良组和死亡组。记录心肌复极异常指标：ST段压低导联数、T波形态学变异（TMDT—wavemorphology）、校正的QT间期离散度（QTe）、QT间期离散度（QTd），检测N末端B型尿钠肽前体（NT—proBNP）水平并观察预后状况，进行相关性分析和Cox回归分析。结果预后不良组和死亡组ST段压低导联数、TMD、QTe、QTd均显著高于预后良好组；死亡组ST段压低导联数、TMD、QTc、QTd均显著高于预后不良组；全部患者ST段压低导联数、TMD、QTe、QTd与NT—proBNP水平均呈显著正相关（均P〈0．05）。年龄、BNP水平、ST段压低导联数、TMD、QTe、QTd均为冠心病心衰预后不良的危险因素。结论心肌复极异常指标对于冠心病心衰的预后具有评估意义和临床应用价值。Objective To investigate the relationship between myocardial repolarization electrocardiogram and the prognosis of coronary heart disease. Methods 98 Patients with coronary heart disease were selected from October in 2014 to October in 2016 in our hospital. They were divided into good prognosis group, poor prognosis group and the death group. Abnormal index of myocardial repolarization including number of ST segment of low lead, morphological variation of T wave （TMD） , QT interval （QTc） and QT dispersion （QTd） were recorded. Nt - Pro BNP levels were detected and the prognosis was observed. Cox regression analysis was done. Results In poor prognosis group and death group number of ST segment of low lead, TMD, QTc and QTd were significantly higher than those in good prognosis group. Number of ST segment of low lead, TMD, QTc and QTd in the death group were signifi- cantly higher than those in poor prognosis group. Number of ST segment of low lead, TMD, QTc, QTd of all patients were positively correlated with NT - pro BNP levels （P 〈 0.05）. Age, BNP levels, number of ST segment of low lead, TMD, QTc and QTd were the risk factors of poor prognosis of coronary heart disease （CHD） with heart failure. Conclusion The assessment of abnormal myo- cardial repolarization parameters were useful in predicting prognosis for patients with CHD with heart failure.

关 键 词：复极异常 心电图 冠心病 心力衰竭 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]