基于ECG-ViEW数据库的心房颤动心电图QT间期校正方法比较  

Comparison among different correction methods of QT interval in patients with atrial fibrillation:Based on ECG-ViEW database

作　　者：张凤至 陈舒宁 徐宗政 王悦 李媛 王德国 ZHANG Fengzhi;CHEN Shuning;XU Zongzheng;WANG Yue;LI Yuan;WANG Deguo(Department of Gerontology,the First Affiliated Hospital of Wannan Medical College,Wuhu Anhui 241001,China)

机构地区：[1]皖南医学院第一附属医院(弋矶山医院)老年医学科,安徽芜湖241001

出　　处：《实用心电学杂志》2023年第5期307-312,共6页Journal of Practical Electrocardiology

基　　金：安徽省科技厅重点研究与开发项目(2022e07020019);国家自然科学基金资助项目(81670301)。

摘　　要：目的探讨心房颤动(简称房颤)患者分别在房颤及窦性节律下,不同QT间期校正方法的应用效果。方法从公共信息平台ECG-ViEW心电图数据库中筛选出同时具有房颤及窦性节律的房颤患者心电图,分别比较和分析Bazett、Fridericia、Framingham及Hodges公式对同一患者在房颤及窦性节律下的QT间期校正效果。分析经不同公式校正的QTc与心率及QT间期测量值之间的线性关系。结果房颤患者心电图QT间期在房颤及窦性节律下比较,差异有统计学意义[(374.57±67.73)ms vs.(396.71±55.68)ms,P<0.01]。经Hodges公式校正后QTc在两种节律下差异无统计学意义,其对心率的回归直线斜率很小,且与QT间期测量值呈较好的线性关系。经临床常用的Bazett公式校正的QTc与QT间期测量值呈正线性关系。结论常用的Bazett及Fridericia、Framingham公式在房颤节律下对心电图QT间期的校正效果欠佳。Hodges公式在房颤及窦性节律下对QT间期的校正效果接近,能较好地消除心率对QT间期的影响。Hodges公式在人群中具有普适性,是监测房颤患者QT间期延长较好的临床指标。Objective To explore the effect of different correction methods of QT interval in patients with atrial fibrillation(AF)separately at AF and sinus rhythms.Methods The ECGs of AF patients both with AF and sinus rhythms were selected from the public information platform ECG-ViEW database.The correction effect of Bazett,Fridericia,Framingham and Hodges formulas is compared and analyzed for the same patient separately at AF and sinus rhythms.The linear relationship between QTc corrected by different formulas and heart rate or the measured value of QT interval was analyzed.Results There is a statistically significant difference in the QT interval among AF patients during AF and sinus rhythms[(374.57±67.73)ms vs.(396.71±55.68)ms,P<0.01].The QTc corrected by Hodges formula does not vary significantly between the two rhythms.The regression line slope of QTc to the heart rate is very small,and the QTc corrected by Hodges formula shows a good linear relationship with the measured value of QT interval.The QTc corrected by commonly used Bazett formula in clinical practice shows a positive linear relationship with the measured value of QT interval.Conclusion Commonly used Bazett,Fridericia and Framingham formulas lead to poor performances in correcting QT interval of ECGs during AF rhythm.The effect of Hodges formula on correcting QT interval is close separately at AF and sinus rhythms,which could greatly reduce the influence of heart rate on QT interval.Hodges formula is universal in the population,and makes a good clinical indicator for monitoring the prolongation of QT interval in AF patients.

关 键 词：QT间期 QTC 心房颤动 心电图 

分 类 号：R541.75[医药卫生—心血管疾病] R540.4[医药卫生—内科学]