老年急性心肌梗死患者心电图T波峰末-间期的表现及其与预后的关系  

Manifestations of T peak to T end interval of ECG in elderly patients with acute myocardial infarction and its relationship with prognosis

作　　者：李汉丽 李易 杨菲[1] LI Han-li;LI Yi;YANG Fei(Functional Department,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;ECG Room,Baoji Traditional Chinese Medicine Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院功能科,陕西宝鸡721000 [2]宝鸡市中医医院心电图室,陕西宝鸡721000

出　　处：《海南医学》2023年第11期1577-1581,共5页Hainan Medical Journal

基　　金：陕西省宝鸡市卫生健康委员会科研计划立项课题(编号:2019-63)。

摘　　要：目的探讨老年急性心肌梗死患者心电图T波峰末-间期的表现及其与预后的关系。方法选择2020年3月至2021年8月宝鸡市人民医院收治的200例老年急性心肌梗死患者作为研究对象,所有患者均接受进行动态心电图监测。根据心律类型将患者分为室性心动过速组66例(室速组)、室性早搏组91例(室早组)和未发生室性心律失常43例(正常组),比较三组患者在介入手术治疗前的校正QT间期(QTc)、T波峰末间期Tp-Te及Tp-Te间期离散度Tp-Ted水平。根据超声心动图检查结果将患者分为重构组61例和非重构组139例,比较两组患者在介入手术治疗前的QTc、Tp-Te及Tp-Ted水平。记录老年急性心肌梗死患者1年内的死亡情况以及介入手术治疗前的梗死程度、左心室重构、室性心律失常等,比较不同预后结果患者在介入手术治疗前的Tp-Te、校正心率后Tp-Te水平;采用二元Logistic回归分析Tp-Te、校正心率后Tp-Te与老年急性心肌梗死患者预后的关系。结果室速组、室早组患者的Tp-Te、校正心率后Tp-Te、Tp-Ted及校正心率后Tp-Ted水平均明显高于正常组,且室速组的上述各项指标均明显高于室早组,差异均有统计学意义(P<0.05);重构组患者的Tp-Te、校正心率后Tp-Te、Tp-Ted及校正心率后Tp-Ted水平均明显高于非重构组,差异均有统计学意义(P<0.05);不同预后的患者中,死亡、多支梗死、发生左心室重构以及室性心律失常患者在介入手术治疗前的Tp-Te、校正心率Tp-Te水平分别明显高于未死亡、单支梗死、未发生左心室重构以及室性心律失常患者,差异均有统计学意义(P<0.05);经二元Logistic回归分析结果显示,Tp-Te、校正心率后Tp-Te是导致老年急性心肌梗死患者不良预后的危险因素(P<0.05),Tp-Te、校正心率后Tp-Te水平越高,老年急性心肌梗死发生死亡、多支梗死、左心室重构和室性心律失常的比例越高。结论老年患者发生急性�Objective To study the manifestations of T peak to T end interval of ECG(Tp-Te)in elderly pa-tients with acute myocardial infarction and to analyze its relationship with prognosis.Methods A total of 200 elderly patients with acute myocardial infarction treated in Baoji People's Hospital from March 2020 to August 2021 were select-ed as the research objects.All patients were monitored by dynamic electrocardiogram.According to the type of arrhyth-mia,the patients were divided into ventricular tachycardia group(66 cases),ventricular premature beat group(91 cases),and without ventricular arrhythmia(normal group,43 cases).The levels of QTc,Tp-Te,and Tp-Te dispersion(Tp-Ted)in the three groups were compared.According to the results of echocardiography,the patients were divided into reconstruc-tion group(n=61)and non-reconstruction group(n=139),and the QTc,Tp-Te,and Tp-Ted levels of the two groups were compared.The death of elderly patients with acute myocardial infarction within one year,the degree of infarction,left ventricular remodeling,and ventricular arrhythmia before interventional therapy were recorded.The levels of Tp-Te and heart rate-corrected Tp-Te in patients with different prognosis were compared.Binary Logistic regression was used to an-alyze the relationship between Tp-Te,heart rate-corrected Tp-Te and prognosis of elderly patients with acute myocardial infarction.Results The levels of Tp-Te,Tp-Ted,and heart rate-corrected Tp-Te,Tp-Ted in ventricular tachycardia group and ventricular premature beat group were significantly higher than those of normal group,and the levels in ven-tricular tachycardia group were significantly higher than those of ventricular premature beat group,with statistically sig-nificant differences(P<0.05).The Tp-Te and heart rate-corrected Tp-Te,Tp-Ted and heart rate-corrected Tp-Ted in recon-struction group were significantly higher than those in the non-reconstructed group(P<0.05).Among the patients with different prognosis,the levels of Tp-Te and heart rate-corrected Tp-Te in pati

关 键 词：老年急性心肌梗死 T波峰末-间期 室性心律失常 左心室重构 预后 

分 类 号：R542.22[医药卫生—心血管疾病]