冠心病患者Tp-e间期与复杂性室性心律失常关系的研究

The Relationship between Tpeak -Tend Interval and Complex Ventricular Arrhythmias in Patients with Coronary Artery Disease

目的观察不同方法（Tmax法、T均法和TV3法）测得的冠心病患者Tp—e间期差异以及其与复杂性室性心律失常的关系。方法315例患者的12导联心电图通过计算机图像软件处理获得Tp—e间期资料，同时行动态心电图检查并按检查结果分组：A组，冠心病单纯室性期前收缩频发组（室性期前收缩≥30次／h）；B组，冠心病复杂性室性期前收缩组（多形性、多源性、R在T上、连发室性期前收缩，可合并室性逸搏）；C组，冠心病室性心动过速、心室扑动及颤动组；D组．冠心病对照组（无明显快速性室性心律失常，室性期前收缩〈30次／h，且无其他室性心律失常）；E组．正常对照组。评价上述3种不同方法测得的Tp-e间期对室性心律失常的预测能力并将Tp—e间期与Q—T间期离散度（Q—Td）进行比较。结果B、C组的Tp-e问期不仅显著大于正常对照组，也显著大于冠心病对照组（P〈0．05）。而A组Tp—e间期大于对照组，但差异无统计学意义（P〉0.05）。结论Tp—e间期对复杂性室性心律失常有预测价值。且优于Q-Td。

Objective To observe the relationship between Tpeak-Tend （Tp-e） interval and complex ventricular arrhythmias in patients with coronary artery disease （CAD）. Methods 315 patients with CAD and ventricular arrhythmias were divided into groups according to the results of ambulatory electrocardiogram;group A with simple ventricular premature beat, group B with polymorphic ventricular premature beat or R-on-T, group C with ventricular tachycardia, fluter or fibrillation and group D without above ventricular arrhythmias. Group E was control group without CAD. The Tp-e interval was measured on 12-lead electrocardiogram and compared between groups. Results The Tp-e interval was significantly greater in group B and C than in group D and E （P 〈 0.05）. There was no significant difference between group A and E, even though the Tp-e interval was greater in group A. Conclusion The Tp-e interval may be of clinical value for predicting complex ventricular arrhythmias in patients with CAD.