Tp-Te间期、Tp-Te/QT比值预测冠状动脉慢血流现象的临床价值  

Clinical value of Tp-Te interval and Tp-Te/QT ratio for predicting coronary slow flow phenomenon

作　　者：雷静 曾珉[1] 王仲华[1] 钟丹丹 LEI Jing;ZENG Min;WANG Zhonghua;ZHONG Dandan(Department of Cardiology,Chenzhou First People's Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院心血管内科,423000

出　　处：《国际心血管病杂志》2022年第1期53-56,59,共5页International Journal of Cardiovascular Disease

摘　　要：目的:探讨T波峰末间期(Tp-Te间期)、Tp-Te间期与QT间期的比值(Tp-Te/QT比值)与冠状动脉慢血流(CSF)的关系及预测价值。方法:选取2017年1月至2019年10月于郴州市第一人民医院就诊并行冠状动脉造影的患者230例,分为CSF组(n=118)和对照组(n=112),记录患者基础数据;通过心肌梗死溶栓试验(TIMI)计帧法计算溶栓帧数(TFC),定量测定冠状动脉血流量,使用心电工作站测定Tp-Te间期、QT间期、Tp-Te/QT比值;采用Pearson相关分析分别对Tp-Te间期、Tp-Te/QT比值与TFC关系进行分析;通过logistic回归预测影响CSF发生的危险因素;通过受试者工作曲线(ROC曲线)探究Tp-Te间期、Tp-Te/QT比值对CSF的预测作用。结果:与对照组相比,CSF组患者的心电图Tp-Te间期、QT间期均显著延长,Tp-Te/QT比值显著增大(P均<0.05),Tp-Te间期和Tp-Te/QT比值均与TFC呈显著正相关(r=0.426和0.363,P均<0.05)。logistic回归分析显示,Tp-Te间期、Tp-Te/QT比值是冠状动脉慢血流现象的独立危险因素。以120.5 ms作为预测CSF的临界值,Tp-Te间期的ROC曲线下面积为0.750,灵敏度为71.5%,特异度为75.6%;以0.20作为预测CSF的临界值,Tp-Te/QT比值的ROC曲线下面积为0.692,灵敏度为76.4%,特异度为80.2%。结论:心电图Tp-Te间期、Tp-Te/QT比值与CSF显著相关,可作为预测CSF的潜在标志物。Objective: To study the relationship between T-wave peak to end(Tp-Te) interval, Tp-Te/QT ratio and coronary slow flow(CSF) phenomenon, and evaluate the predictive value of Tp-Te interval and Tp-Te/QT ratio. Methods:From January 2017 to October 2019, 230 patients who underwent coronary angiography in Chenzhou First People’s Hospital were included, and were divided into CSF group(n=118 cases) and control group(n=112) by diagnosis. Characteristics basic data of these patients were recorded. The coronary blood flow was measured by thrombolysis frame number(TFC), which was calculated with indicators of thrombolytic therapy for myocardial infarction(TIMI). The values of Tp-Te interval and QT interval were measured by ECG workstation, and Tp-Te/QT ratio was calculated. Pearson correlation analysis was used to analyze the relationships between Tp-Te interval, Tp-Te/QT ratio and TFC. Logistic regression was used to predict risk factors of CSF. The receiver operating characteristic(ROC) curve was drawn to explore the predictive value of Tp-Te interval and Tp-Te/QT ratio for CSF. Results:Compared with the control group, Tp-Te interval and QT interval in CSF group were significantly longer, and TP-Te/QT ratio was higher(all P<0.05). There was a statistically significant positive correlation between Tp-Te interval and Tp-Te/QT ratio(r=0.426 and 0.363, respectively, both P<0.05). The results of logistic regression analysis showed that Tp-Te interval and Tp-Te/QT ratio were independent risk factors for CSF phenomenon. The area under the curve of Tp-Te interval for predicting CSF was 0.750, and the cut-off value was 120.5 ms with 71.5% sensitivity and 75.6% specificity. The area under the curve of TP-Te/QT ratio for predicting CSF was 0.692, and the cut-off value was 0.20 with 76.4% sensitivity and 80.2% specificity.Conclusion:Tp-Te interval and Tp-Te/QT ratio, measured by ECG, are significantly correlated with CSF, which could be used as potential landmarks for predicting CSF.

关 键 词：T波峰末间期 Tp-Te/QT比值 冠状动脉 慢血流 

分 类 号：R541.4[医药卫生—心血管疾病]