摘要
目的 :探讨心室晚电位 (VLP)、QT离散度 (QTd)、校正QT离散度 (QTcd)对急性心肌梗塞 (AMI)患者恶性室性心律失常事件发生的预测价值。方法 :测定 6 4例AMI患者和 30例健康人的VLP、QTd、QTcd ,并对AMI患者随访 1年。结果 :AMI组VLP阳性率 (4 2 2 % )较对照组 (6 7% )明显增高 (P <0 0 1) ,QTd、QTcd分别为 74 2± 18 4ms和 81 3± 2 2 6ms较对照组 (2 8 4± 10 6ms和 34 8± 15 3ms)明显延长 (P <0 0 1)。 6 4例AMI患者随访 1年发生恶性室性心律失常事件 18例 ,其中VLP阳性率、QTd、QTcd分别为 88 9%、86 5± 2 7 4ms、93 6± 34 8ms和非事件组(2 3 9%、6 2 7± 2 4 3ms、6 9 4± 2 5 2ms)比较 ,差异有显著性 (P <0 0 1)。在预测AMI患者恶性室性心律失常事件发生的敏感性 ,特异性和有效性QTd分别为 6 6 5 %、85 4%、78% ,QTcd分别为 72 4%、71 3 %、71% ,VLP分别为42 6 %、92 8%、6 8%。结论 :VLP(+ )和QTd、QTcd明显延长与AMI患者发生恶性室性心律失常事件密切相关 ,并可作为AMI患者预后和恶性室性心律失常事件发生可靠的 ,非侵入性预测指标。其中以QTcd敏感性最高 ,VLP(+ )最具特异性。
Objective: To study the value of ventricular late potiential (VLP), QT dispersion (QTd) and corrected QT dispersion(QTcd) in predicting malignant ventricular arrhythmias in patients with acute myocardial infarction(AMI). Methods: VLP QTd and QTcd were measured in 64 patients with AMI and 30 healthy persons and all patients with AMI were followed up for one year.Results: The positive rate of VLP in patients with AMI was 42.2%. The QTd and QTcd of patents with AMI (74.2±18.4ms and 81.3±22.6ms) were significantly longer than those of the controls(28.4±10.6ms and 34.8±15.3ms)(P<0.01), VLP, QTd and QTcd in malignant ventriculer arrhythmia incident group of AMI significantly differed from those in non-incident group(P<0.01). The sensitivity, specificity and efficiency for the prediction of malignant ventricular arrhythmia events in patients with AMI were 66.5%, 85.4%, 78% in QTd study, 72.4%,71.3%,71% in QTcd study and 42.6%, 92.8%, 68% in VLP study. Conclusion: The above data suggested that positive rate of VLP and prolongation of QTd and QTcd were closely associated with malignant ventricular arrhythmia events in AMI. They might serve as a reliable and non-interventional method for the prediction of malignant ventricular arrhythmia events in AMI.
出处
《泸州医学院学报》
2001年第1期22-24,共3页
Journal of Luzhou Medical College
