摘要
目的观察微伏级T波电交替、平板运动试验结果、经心率校正的QT间期（QTc）和室性心律失常发生的关系,为临床判断患者病情和预后提供参考。方法选择我院内科2011年8月至2012年7月行平板运动试验的患者260例,其中男性140例,女性120例,采用GE公司提供的MarquetteT波电交替（TWA）分析程序,进行标准时域运动试验,最后对每例患者的性别、年龄、TET、MTWA、QTC等指标进行分析。结果 260例患者中TET阳性86例,TET阴性174例,TWA阳性42例,TWA阴性219例,所有病例中发生室性心律失常59例,QTc延长142例,双水平logistic回归分析显示TET阳性者发生室性心律失常的风险增加2.37倍（p=0.018,95%可信区间1.163-4.841）;MTWA阳性者发生室性心律失常的风险增加7.213倍（p=0.000,95%可信区间3.178-16.372）;男性较女性更易出现室性心律失常（OR值2.239,p=0.020,95%可信区间1.135~4.418）。结论 TET和MTWA阳性者发生室性心律失常的风险显著增加,男性患者更容易发生室性心律失常,临床上对怀疑有冠心病的男性患者应该积极进行TET和MTWA检测,以尽早发现高危患者并给予相应的干预措施。
Objective To observe the relationship of treadmill exercise test （TET）, microvolt T-wave alternants （MTWA）, QTc and ventricular arrhythmias. Methods We enrolled 260 patients who had undergone treadmill exercise test, GE Healthcare’s TWA MMA analysis programs are used in conjunction with standard clinical assessment of routine exercise stress testing. Differences of gender, age, TET, MTWA and QTc, and the relationship between these items and ventricular arrhythmias were analyzed. Results Of all patients, the number of TET positive and negative are 86 and 174; MTWA positive and negative are 42 and 219. 142 patients have QTc prolong, 59 patients had ventricular arrhythmias. Bi-logisitic analysis show the odds ratio for ventricular arrhythmias for patients with TET positive was 2.37 （95% CI：1.163-4.841, p=0.018）. The odds ratio for ventricular arrhythmias for patients with MTWA positive was 7.213 （95% CI：3.178-16.3721, p=0.001）. The risk for ventricular arrhythmias in man is more than two fold than women （odds ratio 2.239, 95% CI：1.135-4.418,p=0.020）. Conclusion The risk in male TET and MTWA positive patients, especially in male MTWA positive patients, has a prominent increase, the instrument item of TET and MTWA deserved to be put in a more important position.
出处
《临床心电学杂志》
2012年第6期428-430,共3页
Journal of Clinical Electrocardiology
