冠心病患者动态心电图检查中P波离散度、T波峰-末间期的变化及诊断价值研究  

Changes and diagnostic value of P-wave dispersion and T peak-T end interval in dynamic electrocardiogram in patients with coronary heart disease

作　　者：古丽尼格尔·吾布力 夏木西娅·哈德尔 印纹源 郭永忠[2] WUBULI·Gulinigeer;HADEER·Xiamuxiya;YIN Wenyuan;GUO Yongzhong(Department of Electrocardiography,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院心电学科,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院心外科,新疆乌鲁木齐830001

出　　处：《陕西医学杂志》2024年第5期620-623,共4页Shaanxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金资助面上项目(2022D01C132)。

摘　　要：目的:探讨冠心病(CHD)患者动态心电图检查中P波离散度(Pd)、T波峰-末(Tp-Te)间期的变化及诊断价值。方法:选取CHD患者203例作为研究组,其中,心肌缺血95例作为心肌缺血组,心肌缺血合并心律失常108例作为心肌缺血合并心律失常组。另取同期体检健康者90例作为对照组。所有受试者均接受动态心电图检查,并记录Pd、Tp-Te间期情况。比较研究组和对照组以及心肌缺血组和心肌缺血合并心律失常组Pd、Tp-Te间期。绘制受试者工作特征曲线(ROC)分析Pd、Tp-Te间期对CHD及CHD心律失常的诊断价值。结果:研究组Pd、Tp-Te间期大于对照组(均P<0.05)。Pd、Tp-Te间期联合诊断CHD的AUC高于两者单独诊断的AUC(均P<0.05)。心肌缺血合并心律失常组Pd、Tp-Te间期大于心肌缺血组(均P<0.05)。Pd、Tp-Te间期联合诊断CHD患者心律失常的AUC高于两者单独诊断的AUC(均P<0.05)。结论:CHD患者动态心电图Pd增加及Tp-Te间期延长,且心肌缺血合并心律失常患者Pd增加及Tp-Te间期延长较心肌缺血患者更为明显,两者联合对CHD及CHD心律失常诊断价值较高。Objective:To explore the changes and diagnostic value of P-wave dispersion(Pd)and T peak-T end(Tp-Te)interval in dynamic electrocardiogram in patients with coronary heart disease(CHD).Methods:A total of 203 patients with CHD were enrolled as study group,including 95 cases with myocardial ischemia in myocardial ischemia group and 108 cases with myocardial ischemia and arrhythmia in arrhythmia group.A total of 90 healthy controls during the same period were enrolled as control group.All the objects underwent dynamic electrocardiogram examination to record Pd and Tp-Te interval.Pd and Tp-Te interval were compared between study group and control group,and between myocardial ischemia group and arrhythmia group.The diagnostic value of Pd and Tp-Te interval for CHD and arrhythmia of CHD was analyzed by receiver operating characteristic(ROC)curves.Results:Pd and Tp-Te interval in study group were higher than those in control group(all P<0.05).AUC of Pd combined with Tp-Te interval in the diagnosis of CHD was greater than that of single index(all P<0.05).Pd and Tp-Te interval in arrhythmia group were higher than those in myocardial ischemia group(all P<0.05).AUC of Pd combined with Tp-Te interval in the diagnosis of arrhythmia was greater than that of single index(all P<0.05).Conclusion:The dynamic electrocardiogram of CHD patients shows an increase in Pd and an extension of Tp-Te interval,and the increase in Pd and an extension of Tp-Te interval are more significant in patients with myocardial ischemia combined with arrhythmia than in patients with myocardial ischemia.The two indexes have high diagnostic value for CHD and arrhythmia of CHD.

关 键 词：冠心病 心律失常 心肌缺血 动态心电图 P波离散度 T波峰-末间期 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]