AMI并发室性心律失常患者QTc、Tp-Tec间期变化及其与心功能的相关性  

Changes of QTc and Tp-Tec intervals in patients with AMI complicated with ventricular arrhythmia and their correlation with cardiac function

作　　者：姚丽红 王亚亚 张媛[1] YAO Lihong;WANG Yaya;ZHANG Yuan(ECG Room of Liaocheng People's Hospital,Liaocheng,Shandong,China,252000)

机构地区：[1]聊城市人民医院心电图室,山东聊城252000

出　　处：《分子诊断与治疗杂志》2023年第12期2075-2078,共4页Journal of Molecular Diagnostics and Therapy

基　　金：山东省科技处医学科技奖(科技创新成果奖)(2015-01-03-69-3)。

摘　　要：目的探讨急性心肌梗死(AMI)并发室性心律失常患者矫正后心室收缩时间(QTc)、校正后T波峰末(Tp-Tec)间期变化,并分析其与心功能的相关性。方法选取2020年6月至2022年12月聊城市人民医院收治的130例AMI患者的临床资料,根据住院期间室性心律失常发生情况分组,其中52例有室性心律失常的患者作为观察组,78例无室性心律失常的患者为对照组。比较两组心功能指标[美国纽约心脏病协会(NYHA)分级、N末端脑利钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)、左室射血分数(LVEF)、每搏输出量(SV)]、QTc、Tp-Tec间期,采用Pearson法分析QTc、Tp-Tec间期与心功能的相关性。结果观察组NYHA分级Ⅲ~Ⅳ级患者多于对照组,NT-proBNP、cTnI水平均明显高于对照组,LVEF、SV均明显低于对照组,差异均有统计学意义(P<0.05);观察组入院时QTc、Tp-Tec间期均明显高于对照组,差异有统计学意义(P<0.05);两组出院时QTc、Tp-Tec间期比较,差异无统计学意义(P>0.05);经Pearson相关性分析显示,QTc、Tp-Tec间期与NYHA分级、NT-proBNP、cTnI均呈正相关,与LVEF、SV均呈负相关(P<0.05)。结论AMI并发室性心律失常患者QTc、Tp-Tec间期明显升高,且QTc、Tp-Tec间期与心功能均具有明显相关性,临床上应予以密切关注。Objective To study the changes of corrected ventricular systolic time(QTc)and corrected T wave peak to end(Tp-Tec)interval in patients with acute myocardial infarction(AMI)complicated with ventricular arrhythmia,and to analyze its correlation with cardiac function.Methods The clinical data of 130 AMI patients admitted to Liaocheng People's Hospital from June 2020 to December 2022 were selected and grouped according to the occurrence of ventricular arrhythmias during hospitalization.Among them,52 patients with ventricular arrhythmia served as the observation group,and 78 patients without ventricular arrhythmia served as the control group.The cardiac function indexes[New York Heart Association(NYHA)grading,N-terminal pro brain natriuretic peptide(NT-proBNP),cardiac troponin(cTnI),left ventricular ejection fraction(LVEF),and stroke output(SV)],QTc and Tp-Tec intervals were compared between the two groups,Pearson method was used to analyze the correlation between QTc,Tp-Tec interval,and cardiac function.Results There were more patients with NYHA gradeⅢ~Ⅳin the observation group than in the control group.The levels of NT-proBNP and cTnI were significantly higher than those in the control group.LVEF and SV were significantly lower than those in the control group.The differences were statistically significant(P<0.05).The QTc and Tp-Tec intervals at admission in the observation group were higher than those in the control group,with statistically significant(P<0.05),there was no statistically significant difference in QTc and Tp-Tec intervals between the two groups at discharge(P>0.05).Pearson correlation analysis showed that QTc and Tp-Tec intervals were positively correlated with the NYHA grading,NT proBNP,cTnI,and negatively correlated with LVEF and SV(P<0.05).Conclusion The QTc and Tp-Tec intervals in AMI patients with ventricular arrhythmia are significantly increased,and there is a significant correlation between QTc,Tp-Tec intervals with cardiac function,which should be closely monitored in clinical practice.

关 键 词：急性心肌梗死 室性心律失常 心电图 矫正后心室收缩时间 校正后T波峰末 

分 类 号：R542.22[医药卫生—心血管疾病] R541.7[医药卫生—内科学]