摘要
目的:分析急性心肌梗死(AMI)患者微伏级T波电交替(MTWA)以及心率变异性(HRV)指标,探讨其对AMI患者住院期间恶性心律失常的预测价值。方法:117例AMI患者(AMI组),男性86例,女性31例;年龄32~84岁,平均年龄(61±11)岁。分析其24 h动态心电图检查资料。依据住院期间有无室速或室颤,将117例AMI患者分为恶性心律失常组(37例)和非恶性心律失常组(80例)。结果:恶性心律失常组与非恶性心律失常组MTWA差异具有显著统计学意义(P〈0.01)。以MTWA≥25μV为截点,MTWA预测AMI患者发生恶性心律失常的灵敏度、特异度、阳性预测值、阴性预测值分别为50.00%、80.28%、54.84%、77.03%。MTWA以及SDNN(SDANN)联合预测恶性心律失常的灵敏度、特异度、阳性预测值、阴性预测值分别为20.59%(20.59%)、94.37%(95.77%)、63.64%(70.00%)、71.28%(71.58%)。结论:MTWA及HRV对AMI患者住院期间恶性心律失常的发生有预测价值,可用于AMI患者的危险分层。
Objective: To investigate the value of microvolt T wave alternans(MTWA) and heart rate variability(HRV) in predicting malignant arrhythmia during hospitalization in patients with acute myocardial infarction(AMI).Methods: A total of 117 AMI patients [male 86,female 31,aged 32~84 years old,mean aged(61±11) years old] were enrolled.The results of 24 hour ambulatory ECG data in117 AMI patients were analysed.117 AMI patients were divided into malignant arrhythmia group(37 cases) and non-malignant arrhythmia group(80 cases) basing on weather they had experienced an episode of ventricular tachycardia(VT) or ventricular fibrillation(VF) during their hospitalization.Results: MTWA showed significant difference(P 0.01) between malignant arrhythmia and non-malignant arrhythmia group.MTWA was positive(MTWA≥25 μV),the sensitivity for diagnosis of malignant arrhythmia in AMI patients was 50.00%,specificity was 80.28%,positive predictive value was 54.84%,and negative predictive value was 77.03%.MTWA and SDNN(SDANN) were positive,the sensitivity was 20.59%(20.59%),specificity was 94.37%(95.77%),positive predictive value was 63.64%(70.00%),and negative predictive value was 71.28%(71.58%).Conclusion: MTWA and HRV of AMI patients could play the predictive role in malignant arrhythmia during hospitalization,and could be used to identify high risk patients from AMI patients.
出处
《天津医科大学学报》
2012年第1期59-62,共4页
Journal of Tianjin Medical University
基金
天津市卫生局科技基金资助项目(09KZ05)
关键词
微伏级T波电交替
心率变异性
急性心肌梗死
恶性心律失常
microvolt T wave alternans
heart rate variability
acute myocardial infarction
malignant arrhythmia