摘要
目的研究心肌缺血对T波峰末间期(Tpeak-Tendinterval,TpTe)的影响,探讨TpTe与心室肌跨壁复极离散度之间的关系。方法选取运动平板试验诱发心肌缺血的冠心病患者25例和运动平板试验阴性的正常对照30例作为研究对象,所有入选对象均经选择性冠状动脉造影证实。记录所有受试者运动平板试验前静息、运动后恢复期第3min的同步15导联心电图。对研究对象分组、分导联进行同期、运动前后的TpTe、TpTe/RR～(1/2)进行分析。结果①运动平板试验前冠心病组在无心肌缺血的静息状态时,TpTe在V2、V6导联上大于正常对照组有显著性差异(p<0.05);而TpTe/RR～(1/2)在V2～V6导联均与正常对照组无显著性差异(p>0.05)。②在对运动平板试验后的冠心病组和对照组进行比较时发现,诱发心肌缺血的冠心病组的TpTe在V2～V5导联大于正常对照组(p<0.05);而TpTe/RR～(1/2)在V2～V4导联大于正常对照组有显著性差异(p<0.05)。③正常对照组在运动后心率增大时,各导联运动后较运动前的TpTe均明显缩短(p<0.05)、TpTe/RR～(1/2)则无显著性差异(p>0.05)。结论①TpTe、TpTe/RR～(1/2)可以作为反映跨壁复极离散度的无创心电学指标。TpTe/RR～(1/2)独立于心率改变可以作为评价跨壁复极离散度的特征性指标;②运动平板试验中TpTe/RR～(1/2)的增大可作为判断心肌缺血发生的一项指标。
Objective To identify the effects of myocardial ischemia to Tpeak-Tend interval （TpTe） and approach the relation between transmural dispersion of repolarization（TDR） and TpTe. Method The objects include 25 coronary artery disease （CAD） patients in whom myocardial ischemia are induced by treadmill exercise test（TET）.30 normal people without myocardial isehemia in TET are regarded as the control group.All the people are validated by coronary angiography investigate （CAG） later.The 15 leads resting electrocardiogram （ECG） before TET and the 15 leads ECG at 3th minutes in stage of recovery are recorded. TpTe and TpTe/ V＇R R are analysed by different groups, different leads in succession or at the same time.Result （1）On resting ECG before TET, the TpTe of CAD group without myocardial ischemia is significantly longer than that of controlled group on V2 and V6 lead （p 〈0.05）. Compared with the controlled group, the CAD group is not different for the TpTe√RR on V2-V6 leads（p 〉0.05）.（2） On V2-V5 leads, the TpTe is significantly longer in the CAD group in which myocardial ischemia are induced than the controlled group （p 〈0.05） after TET. At the same time, TpTe is significantly longer in the CAD group than the con- trolled group on V2-V4 leads（p 〈0.05）; （3）Because of heart rate increasing, the TpTe is shorten （p 〈0.05） but the TpTe√RR of the controlled group is not different（p 〉0.05） after TET. Conclusion （1）Both TpTe and TpTe√RR can be taken as electrocardiological indexes of TDR. TpTe represent the actual value of TDR. TpTe√RR represent characteristic of TDR; （2）During TET, increasing of TpTe/can be regarded as an index of myocardial ischemia.
出处
《临床心电学杂志》
2008年第4期288-291,共4页
Journal of Clinical Electrocardiology
关键词
心肌缺血
T波峰末间期
跨壁复极离散度
myocardial ischemia
Tpeak-Tend interval （TpTe）, transmural dispersion of repolarization（TDR）
