变异性心绞痛病人心电图检测对恶性室性心律失常的临床预测价值

    The clinical predictive value of electrocardiogram in patients with variant angina for malignant ventricular arrhythmia

    • 摘要:
      目的探讨变异型心绞痛(VA)病人心电图检测对恶性室性心律失常(MVA)的临床预测价值。
      方法选取确诊为VA病人136例,按是否合并MVA分为MVA组和NMVA组,各68例。2组病人均行心电图检测,比较2组病人的心电图参数,并预测其MVA的可能性。
      结果病人急性发作期,MVA组心电图参数QT间期(cQT)、QT间期离散度(cQTd)、校正的T波峰到T波末端的间期(cTp-e)、校正的Tp-e离散度(cTp-ed)、T波峰到T波末端的间期/QT间期(Tp-e/QT)、ST段抬高程度(STE)值均高于NMVA组(P < 0.05~P < 0.01);ROC曲线分析表明,cTp-e、cTp-ed、Tp-e/QT、STE的ROC曲线下面积值均大于cQTd(P < 0.05),Tp-e/QT大于cTp-ed、STE(P < 0.05),cTp-ed与STE差异无统计学意义(P>0.05),故cQTd、STE的预测价值中等,cTp-e、cTp-ed、Tp-e/QT的预测价值高。cTp-ed、Tp-e/QT和VA病人发生MVA密切关联(P < 0.05)。
      结论心电图检测指标中cQTd、cTp-e、cTp-ed、Tp-e/QT、STE能预测MVA的发生,其中cTp-ed、Tp-e/QT两项参数的预测价值较高,可当作预测VA病人发生MVA的首要观察指标。

       

      Abstract:
      ObjectiveTo explore the clinical predictive value of electrocardiogram in patients with variant angina(VA) for malignant ventricular arrhythmia(MVA).
      MethodsOne hundred and thirty-six patients with VA were divided into the NMVA group and MVA group according to whether to merge MVA(68 cases each group).The electrocardiogram in two groups were detected.The ECG parameters between two groups were compared and the likelihood of MVA was predicted.
      ResultsDuring acute exacerbation, the QT interval(cQT), QT interval dispersion(cQTd) of the electrocardiogram parameters, corrected T-peak to the end of the T-wave(cTp-e), corrected Tp-e dispersion(cTp-ed), interval between the T wave peak and T wave end(Tp-e/QT) and ST segment elevation(STE) value in MVA group were significantly higher than those in NMVA group(P < 0.05 to P < 0.01).The results of ROC curve analysis showed that the area under the ROC curve (AUC) of cTp-e, cTp-ed, Tp-e/QT and STE were significantly larger than those of cQTd(P < 0.05), which of Tp-e/QT was significantly greater than that of cTp-ed and STE(P < 0.05), and there was no statistical significance that of between cTp-ed and STE(P>0.05).The predictive value of cQTd and STE were moderate, and the predictive value of the cTp-e, cTp-ed and Tp-e/QT were high.The cTp-ed and Tp-e/QT were closely related to the MVA in VA patients(P < 0.05).
      ConclusionThe cQTd, cTp-e, cTp-ed, Tp-e/QT and STE can predict the occurrence of MVA.The predictive value of cTp-ed and Tp-e/QT are higher, and which can be used as the primary observation indicators to predict the occurrence of MVA in patients with VA.

       

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