无结构性心脏病患者频发室性期前收缩对心肌复极的影响  

Effect of frequent ventricular premature contractions on myocardial repolarization in patients without structural heart disease

作　　者：王萌 程自平 刘兆平 陈晨[1] 杨辉 何静 范彬 陈永恒 WANG Meng;CHENG Zi-ping;LIU Zhao-ping;CHEN Chen;YANG Hui;HE Jing;FAN Bin;CHEN Yong-heng(Department of Cardiology,The Fourth Hospital of Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学第四附属医院心血管内科,合肥230000

出　　处：《岭南心血管病杂志》2021年第3期268-272,共5页South China Journal of Cardiovascular Diseases

基　　金：安徽医科大学校科研基金(项目编号:2019xkj153)。

摘　　要：目的探讨无结构性心脏病患者室性期前收缩频次与心肌复极指标的关系。方法入选2018年1月至2020年10月安徽医科大学第四附属医院146例无结构性心脏病室性期前收缩患者,采用12导联心电图计算患者的心肌复极指标(Tpe间期、Tpe/QT和Tpe/QTc),采用24 h动态心电图计算其室性期前收缩负荷。全部患者室性期前收缩负荷为4.72%±1.93%,根据室性期前收缩负荷分为3组:<1%组(50例)、1%~5%组(50例)、>5%组(46例)。结果室性期前收缩负荷>5%组患者的Tpe和Tpe/QTc显著大于室性期前收缩负荷<1%组及1%~5%组,差异有统计学意义(P<0.05)。室性期前收缩负荷>5%组患者的Tpe和Tpe/QTc与室性期前收缩负荷呈正相关。V_(5)导联中Tpe间期(β=1.309,P=0.042)和Tpe/QTc比值(β=-402.129,P=0.022)是室性期前收缩负荷增加的独立预测因子。结论无结构性心脏病患者高负荷室性期前收缩可能造成心肌复极离散度增加,进而有可能导致恶性室性心律失常。Objectives To investigate the relationship between ventricular premature contraction frequency and myocardial repolarization index in patients without structural heart disease.Methods A total of 146 patients with ventricular premature contraction without structural heart disease were enrolled in The Fourth Hospital of Anhui Medical University from January 2018 to October 2020.Twelve lead electrocardiogram(ECG)was used to calculate the indexes of myocardial repolarization(Tpe interval,Tpe/QT and Tpe/QTc),and 24-hour Holter was used to calculate the load of ventricular premature contractions.The patients were divided into three groups according to the ventricular premature contraction load:<1%group(50 cases),1%-5%group(50 cases)and>5%group(46 cases).Results The Tpe and Tpe/QTc in group with ventricular premature contraction load>5%were significantly higher than those in group with ventricular prematurecontraction load<1%and 1%-5%.The Tpe and Tpe/QTc in group with ventricular premature contraction load>5%positively correlated with ventricular premature contraction load.Tpe interval(β=1.309,P=0.042)and Tpe/QTc ratio(β=-402.129,P=0.022)in lead V_(5) were independent predictors of increased ventricular premature contraction load.Conclusions High load premature ventricular contractions in patients without structural heart disease may increase dispersion of myocardial repolarization,which may lead to malignant ventricular arrhythmias.

关 键 词：无结构性心脏病 室性期前收缩负荷 心肌复极 

分 类 号：R541.7[医药卫生—心血管疾病]