从动态心电图中实测的QT间期与不同公式计算的校正QT间期的比较  

Comparison of QT interval measured from Holter and corrected QT interval calculated by different formulas

作　　者：周纪宁[1] 刘文通 向晋涛[1] 来欣[1] 叶丽娟[1] 陈元秀[1] ZHOU Ji-ning;LIU Wen-tong;XIANG Jin-tao;LAI Xin;YE Li-juan;CHEN Yuan-xiu(Department of Cardiology,Renming Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2020年第4期370-375,共6页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨真实QT间期的变化,并评价不同公式计算的校正QT(QTc)间期的准确程度。方法从动态心电图心电数库812例中,随机抽取100例原始长程心电图数据,采用直方图及逆向技术获取心率在50、60、70、80次/分时的片段12导联心电图,截屏并以图片形式(JPG格式)保存心电图。使用Windows照片查看器阅读心电图,将心电图放大到适当的比例,以肉眼辨析清晰,QT间期起止点明确为准,用目测数格子的方法测量QT间期,并在相应的Excel表格中的序排记录QT间期值。利用Excel表格作相应的数据处理。以60次/分测得的QT间期为标准的QTc值,分别采用6个QTc间期计算公式(Framingham、Bazett、Fridericia、Dmitrienko、QTcMod、Hodges)计算50、70、80次/分心率点时的QTc间期,并与之相比较。结果 100例入选,男53例,女47例,年龄(53±14)岁。在心率50、60、70和80次/分时,QT间期变化的趋势随心动周期的变短而变短(正常组)42例;而在与60次/分标准心率的QT间期相比较,分别在1个或2个心率点测量时,却表现为QT间期随心动周期的变化呈反向变化(异常组)有58例。在50次/分时,QTcMod公式计算的QTc值最接近金标准;而在70、80次/分时,则Hodges公式计算的QTc值最接近标准的QT间期。在男性中,在3个心率点时,都是Hodges公式计算出的QTc最接近标准的QT间期;而在女性中,只在50次/分时,Fridericia公式计算出的QTc间期最接近标准的QT间期,另两个心率点则其表现与男性相同。青年组(19~40岁)与中年组(41~60岁)均在50次/分时,QTcMod公式计算的QTc间期最接近于标准的QT间期;而70、80次/分时,Hodges公式计算的QTc间期最接近于标准的QT间期。老年组(>60岁)在3个心率点都表现为Hodges公式计算的QTc间期最接近标准的QT间期。在正常组中,总体上,Framingham和QTcMod公式计算的QTc间期具有同等功效,最接近标准的QT间期;而在男性、女性中分别为Hodges、Bazett公式计Objective To investigate the changes of real QT interval and evaluate the accuracy of different formulas for QTc interval. Methods From 812 cases of Holter database, 100 cases of original long-range ECG data were randomly selected, The 12 lead ECG with heart rate of 50,60,70,80 beats/min was obtained by histogram and reverse technology. The ECG was saved in the form of pictures(JPG format). Use windows photo viewer to read ECG, The ECG was magnified to an appropriate scale. The QT interval was measured by visual counting grid method, and the QT interval value was recorded in the corresponding excel table. Make use of Excel to do the corresponding data processing. Six QTc interval calculation formulas(Framingham, Bazett, Fridericia, Dmitrinko, QTcMod, Hodges) were used to calculate QTc intervals at 50, 70 and 80 bpm, and were compared with those measured at 60 bpm. Results There were 53 males and 47 females with an age of(53±14) years. At 50,60,70 and 80 beats/min,the change trend of QT interval was shortened with the shortening of cardiac cycle(normal group)in 42 cases;compared with QT interval of standard heart rate of 60 beats/min,when measured at one or two heart rate points,the QT interval showed a reverse change with the change of cardiac cycle(abnormal group)in 58 cases.At 50 beats/min,the QTc value calculated by QTcMod formula was closest to the gold standard,while at 70 and 80 times/min,the QTc value calculated by Hodges formula was the closest to the standard QT interval.In women,only at 50 beats/min,the QTc interval calculated by Fridericia formula was closest to the standard QT interval,and the other two heart rate points showed the same performance as men.The QTc interval calculated by the QTcMod formula was the closest to the standard QT interval at 50 beats/min in the young group(19-40 years old)and the middle-aged group(41-60 years old),while the QTc interval calculated by Hodges formula was the closest to the standard QT interval at 70 and 80 beats/min.The QTc interval calculated by Hodges formul

关 键 词：心血管病学 心电图 QT间期 QT间期校正公式 动态心电图 

分 类 号：R540.41[医药卫生—心血管疾病]