摘要
目的：探讨冠心病患者急性心肌缺血对 Ｑ Ｔ 离散度（ Ｑ Ｔｄ）、校正后的 Ｑ Ｔ 离散度（ Ｑ Ｔｃｄ）的影响及其与室性心动过速（简称室速）、心室颤动（简称室颤）的关系。方法：选择７１例确诊为冠心病心绞痛的患者，分成室速室颤组（１３例）和非室速室颤组（５８例），测定每例患者心绞痛发作前、发作时及发作后的 Ｑ Ｔｄ、 Ｑ Ｔｃｄ。结果：心绞痛发作时 Ｑ Ｔｄ、 Ｑ Ｔｃｄ 均显著大于心绞痛发作前和发作后（均 Ｐ ＜ ０．０１），后两者比较无显著性差异（ Ｐ ＞ ０．０５）。室速室颤组心绞痛发作时 Ｑ Ｔｄ、 Ｑ Ｔｃｄ均显著大于非室速室颤组（均 Ｐ ＜ ０．０１）。心绞痛发作前以 Ｑ Ｔｄ≥８０ ｍ ｓ 为标准，则预测室速室颤发生的敏感性为５３．８％ ，特异性为８２．８％ ，准确性为７７．５％ ；心绞痛发作时以 Ｑ Ｔｄ≥１００ ｍ ｓ 为标准，则预测室速室颤发生的敏感性为９２．３％ ，特异性为８４．５％ ，准确性为８５．９％ 。结论：冠心病患者急性心肌缺血时 Ｑ Ｔｄ、 Ｑ Ｔｃｄ 显著增大，易发生室速室颤。急性心肌缺血时的 Ｑ Ｔｄ、 Ｑ Ｔｃｄ 变化可能是预测室速室颤发生更为敏感的指标。
Objective:To investigate the effect of acute myocardial ischemia on QT dispersion (QTd) and corrected QT dispersion (QTcd) in patients with coronary heart disease (CHD) and the relation with ventricular tachycardia (VT) and fibrillation (Vf). Method:The changes of QTd and QTcd were measured before,during and after angina pectors in 71 pts with CHD. They were divided into two groups, one with VT and Vf (13 cases) and one without VT and Vf (58 cases).Result:QTd and QTcd were significantly increased in pts during attack of angina pectoris than those before and after attack (all P< 0.01 ). While,no difference was found between the latter two (P> 0.05 ). During angina pectoris, QTd and QTcd were significantly increased in VT and Vf group than without VT and Vf (all P< 0.001 ). Before angina pectoris, the standard value of QTd≥80 ms had a sensitivity of 53.8 %, specificity of 82.8 % and accuracy of 77.5 % to predict the occurrence of VT and Vf.During angina pectoris, the standard value of QTd≥100 ms had a sensitivity of 92.3 %, specificity of 84.5 %, and accuracy of 85.9 % for the prediction of VT and Vf. Conclusion:QTd and QTcd were significantly increased in presence of acute myocardial ischemia and the episode of VT and Vf in pts with CHD. Thus, the changes of QTd and QTcd in acute myocardial ischemia can be used as a sensitive index for the prediction of episode of VT and Vf.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
1999年第8期360-362,共3页
Journal of Clinical Cardiology
关键词
心肌缺血
心动过程
室性
心室颤动
QT离散度
Angina pectoris Myocardial ischemia Ventricular tachycardia Ventricular fibrillation Electrocardiography
