T波峰-末间期与冠状动脉狭窄程度的关系

Relationship between Tpeak-Tend interval and coronary artery stenosis and effects of percutaneous transluminal coronary angioplasty on Tpeak-Tend

目的探讨T波峰-末间期(Tpe)与冠状动脉狭窄程度和范围的关系及经皮冠状动脉腔内成形术和支架置入术(PCI)对其影响。方法分析187例行选择性冠状动脉造影的冠心病患者的心电图资料,观察不同狭窄程度和病变范围的患者行PCI治疗前后Tpe的变化。结果重度狭窄组Tpe(138.9±16.2ms)高于中度狭窄组(116.5±13.7ms),中度狭窄组Tpe高于轻度狭窄组(86.4±12.9ms),差异均有统计学意义(P<0.05)。三支病变组Tpe(140.7±17.8ms)高于双支病变组(118.6±14.9ms),双支病变组高于单支病变组(100.5±13.2ms),单支病变组高于无病变组(84.3±12.4ms),差异均有统计学意义(P<0.05)。Tpe与冠状动脉狭窄程度及病变支数呈正相关(r=0.52、0.46,P<0.05)。重度狭窄组行PCI术后2、24h和术后1周Tpe降低,与术前比较差异均有统计学意义(P<0.05)。结论 Tpe可反映冠状动脉的狭窄程度和病变范围,成功的PCI术可明显缩短冠状动脉重度狭窄患者的Tpe,Tpe可以成为判断冠心病患者心肌缺血程度的新指标。

Objective To explore the relationship between Tpeak-Tend interval （Tpe） and the extent and severity of cornoary artery stenosis, and evaluate the effect of percutaneous transluminal coronary angioplasty and stent implantation （PCI） on Tpe in the patients with coronary heart disease （CHD）. Methods The ECG data were collected from 187 CHD patients undergoing coronary angiograply and PCI to evaluate the extend and severity of coronary artery stenosis before and after the interventions. Results The Tpe of patients with severe stenosis increased significantly as compared with that in patients with moderate stenosis （138.9±16.2 ms vs 116.5±13.7 ms, P〈0.05）, and a significant difference was also noted between the moderate stenosis and mild stenosis （86.4±12.9 ms） groups （P〈0.05）. The Tpe decreased significantly in the patients in the order of multi-vessel involvement （140.7±17.8 ms）, double vessel involvement （118.6±14.9 ms）, singly vessel involvement （100.5±13.2 ms）, and stenosis-free （84.3±12.4 ms） groups （P〈0.05）. Tpe was correlated to the extent and severity of cornoary artery stenosis （r〉0.4）. In patients with severe stenosis, the Tpe was significantly reduced at 1 h, 24 h, and 1 week after PCI （115.8±14.5, 92.7±12.9, and 88.2±11.3 ms, respectively, P〈0.05）. Conclusion The Tpe can reflect the severity and range of coronary artery stenosis, which can be reduced by PCI. Tpe can be a new index for evaluating myocardial ischemia in CHD patients.