ST/T比值对急性心包炎与早期复极综合征的鉴别诊断价值

The value of ST/T ratio in the differential diagnosis between early repolarization and acute pericarditis

目的 :探讨ST/T比值对急性心包炎与早期复极综合征的鉴别诊断价值。方法 :测量 6 0例急性心包炎 (实验组 )的Ⅰ、Ⅱ、V4、V5、V6导联ST段抬高的幅度及T波振幅 ,计算同导联ST/T比值 ,用ROC曲线分析法确定各导联ST/T比值的诊断界点 ,使用Youden指数确定最佳诊断界点。并以 80例早期复极综合征病人为对照组比较上述指标。结果 :实验组的T波振幅明显小于对照组 (P <0 0 5 ) ;ST/T比值则明显大于对照组 (P <0 0 5 ) ;实验组的ST/T比值的诊断界点在Ⅰ、Ⅱ、V4、V5、V6导联分别为 0 2 9、 0 34、 0 31、 0 2 8、 0 2 7,其中以V6导联ST/T比值大于 0 2 7为最佳诊断界点 ,其真阳性率为 95%、假阳性率为 5 %。结论 :ST/T比值是鉴别急性心包炎与早期复极综合征的可靠指标 ,V6导联ST/T比值大于 0 2 7提示急性心包炎。

Objective:To study the value of ST/T ratio in the differential diagnosis between early repolarization and acute pericarditis.Methods:One hundred and forty cases were divided into control group composed of 80 cases with typical early repolarization and experimental group composed of 60 cases with acute pericarditis. The amplitude of S-T segment elevation and the amplitude of T wave in leads Ⅰ, Ⅱ, V 4, V 5 and V 6 of all cases were measured and the ratio ST to T was calculated in the same lead.Results:The amplitude of T wave in group control was significantly greater than that in experimental group (P<0.05). The ST/T in leads Ⅰ,Ⅱ, V 4, V 5 and V 6 in control group was significantly less than that in experimental group. In 77 out of 80 cases in control group, the ratio ST/T was less than 0.27, and in 60 out of 57 cases in experimental group, the ratio ST/T was greater than 0.27. There was a significant difference(P<0.05) between two groups. ST/T ratio>27 in lead V 6 was suggestive of acute pericarditis.Conclusion:The ratio ST/T in lead V 6 is a reliable criterion for differential diagnosis between early repolarization and acute pericarditis. ST/T ratio >0.27 in lead V 6 is highly suggestive of acute pericarditis.