AMI患者PCI术后心电图ST-T、Tp-e/QT比值及其与预后的相关性  

ST-T,Tp-e/QT ratio of electrocardiogram in patients with acute myocardial infarction after percutaneous coronary intervention and their correlation with prognosis

作　　者：王晓东[1] 白雪蕾 王喜欢[2] 陈鹏[3] WANG Xiao-dong;BAI Xue-lei;WANG Xi-huan;CHEN Peng(Heart Physiology Laboratory,the Second People's Hospital of Nanyang City,Nanyang 473000,Henan,CHINA;Cardiovascular DepartmentⅠ2,the Second People's Hospital of Nanyang City,Nanyang 473000,Henan,CHINA;Cardiovascular Surgery,the Second People's Hospital of Nanyang City,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市第二人民医院心脏生理实验室,河南南阳473000 [2]南阳市第二人民医院心血管内科一病区,河南南阳473000 [3]南阳市第二人民医院心脏大血管外科,河南南阳473000

出　　处：《海南医学》2024年第17期2443-2447,共5页Hainan Medical Journal

基　　金：2019年度河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191464)。

摘　　要：目的研究急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后心电图ST-T、T波峰末间期(Tp-e)/QT比值及其与预后的相关性。方法回顾性分析2021年2月至2023年4月南阳市第二人民医院收治的120例AMI患者的临床资料,根据PCI术后6个月患者的预后情况分为预后不良组(n=18)和预后良好组(n=102),比较两组患者PCI术后ST-T段回落情况、术前Tp-e/QT比值,采用多因素COX回归分析AMI患者PCI术后预后的影响因素,绘制受试者工作特征(ROC)曲线分析ST-T段回落、术前Tp-e/QT比值对AMI患者预后的预测价值。结果预后不良组患者的ST-T段<50%、术前Tp-e/QT比值分别为77.78%、0.34±0.05,明显高于预后良好组的13.73%、0.27±0.04,差异均有统计学意义(P<0.05);COX回归分析结果显示,ST-T段<50%、术前Tp-e/QT比值均是AMI患者PCI术后预后的危险因素(P<0.05);ROC曲线分析结果显示,ST-T段回落、术前Tp-e/QT比值对AMI患者PCI术后预后预测的曲线下面积(AUC)分别为0.686、0.747,特异度分别为61.50%、81.42%,敏感度分别为80.00%、85.31%。结论AMI患者心电图ST-T段回落不良、Tp-e/QT比值增加是PCI术后预后不良的危险因素,临床应加强对此类患者的干预,以减少心血管不良事件的发生。Objective To study the ST-T,T-peak-end interval(Tp-e)/QT ratio of electrocardiogram(ECG)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and their correlation with prognosis.Methods The clinical data of 120 AMI patients admitted to the Second People's Hospital of Nanyang City from February 2021 to April 2023 were retrospectively analyzed.According to the prognosis of patients at 6 months after PCI,the patients were divided into a good prognosis group(n=18)and a poor prognosis group(n=102).The ST-T segment decline and preoperative Tp-e/QT ratio of the two groups were compared,and the influencing factors of progno-sis of AMI patients after PCI were analyzed by multivariate COX regression.Receiver operating characteristic(ROC)curve was drawn to analyze the prognostic value of ST-T segment regression and preoperative Tp-e/QT ratio in AMI pa-tients.Results In patients with poor prognosis,the ST-T segment<50%and preoperative Tp-e/QT ratio were 77.78%and 0.34±0.05,which were significantly higher than 13.73%and 0.27±0.04 in good prognosis group(P<0.05).COX re-gression analysis showed that ST-T segment<50%and preoperative Tp-e/QT ratio were risk factors for the prognosis of AMI patients after PCI(P<0.05).ROC curve analysis results showed that the area under curve(AUC)of ST-T segment regression and preoperative Tp-e/QT ratio for predicting the prognosis of AMI patients after PCI were 0.686 and 0.747,with the specificity of 61.50%and 81.42%and sensitivity of 80.00%and 85.31%,respectively.Conclusion Poor re-gression of ST-T segment and increased Tp-e/QT ratio in patients with AMI are risk factors for poor prognosis after PCI.Clinical intervention should be strengthened for these patients to reduce the occurrence of adverse cardiovascular events.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 ST-T段回落 T波峰末间期/QT间期比值 预后 

分 类 号：R542.22[医药卫生—心血管疾病]