心率变异、心室晚电位、Q-T离散度对心肌梗塞患者心脏事件发生的预测价值

The value of heart rate variability, late potential, QT Dispersion in predicting cardiac events after myocardial infarction

５０例心肌梗塞（ＭＩ）患者短时心率变异（短时ＨＲＶ）、心室晚电位（ＶＬＰ）、和Ｑ－Ｔ离散度（Ｑ－Ｔｄ）三项指标的测定，与３０例正常人进行对比分析，结果表明：梗塞组短时ＲＲ标准差（ＳＤＲＲ）及立卧位心率差值均较对照组明显缩小（Ｐ＜０．００１，Ｐ＜０．００５），ＶＬＰ阳性率明显增高（Ｐ＜０．０２５），Ｑ－Ｔｄ明显延长（Ｐ＜０．００１）。梗塞患者事件组与非事件组三项指标比较相差显著（Ｐ＜０．００１～０．００５）。事件组分类后三项指标对“猝死”的价值最大。在对心脏事件发生的预测方面，敏感性最高的是短时ＳＤＲＲ，特异性最高是ＶＬＰ，有效性最高的是Ｑ－Ｔｄ，相对危险性依次为ＶＬＰ、Ｑ－Ｔｄ、短时ＳＤＲＲ，说明该三项指标均有较高的预测价值。如果同时监测可见随着异常指标项目的增加其预测价值更可靠，临床意义更大。

The transient heart rate variability (transient HRVt), ventricular late potential (VLP) and QT dispersion (QTd) in 50 patients with myocardial infarction (MI) were compared with 30 normal subjects. The results demonstrated: the transient standard deviation RR (SDRR) and the differences of heart rate in standing position and decubitus were remarkably decreased ( P <0.001, P < 0.005). The positive percentage of VLP was obviously increased ( P <0.025). QTd was significantly prolonged ( P <0.001). All these indices in incident groups notedly differed from non incident group ( P <0.001 0.005), especially for sudden death. SDRR was the most closed for sensibility, VLP for specificity and QTd for efficiency respectively, in the prediction for heart incident of MI. The relative posibility of risk was VLP, QTd, transient SDRR in turn. If these indications were detected at the same time, the value of these indices in prediction will be increased and more reliable.