急性心肌梗死患者Tp-Te间期与Tp-Te/QT比值的价值探讨

Exploration ealue of Tp-Te interval and Tp-Te /QT ratio for the treatment of acute myocardial infarction

目的探讨Tp-Te间期与Tp-Te/QT比值对急性心肌梗死(Acute Myocardial Infarction AMI)患者发生恶性心律失常的判断价值。方法选取2011年1月—2012年12月温州医科大学附属第一医院收治的AMI患者80例作为观察组,选择同期健康体检者100人作为对照组,采集2组研究对象的QTc、Tp-Te间期以及Tp-Te/QT比值进行分析,选择QTc 440 ms、Tp-Te间期100 ms、Tp-Te/QT 0.25为节点,对80例AMI患者中恶性心律失常事件(Malignant arrhythmia events,MAE)的发生情况进行分析。结果观察组术前QTc、Tp-Te间期以及Tp-Te/QT的值分别为(432.3±18.2)ms、(107.5±12.3)ms和(0.249±0.031),均显著高于对照组[(352.1±15.5)ms、(80.4±9.1)ms和(0.228±0.025)],差异具有统计学意义(t=31.92,16.98,5.032,P<0.05);观察组术后1周的QTc、Tp-Te间期以及Tp-Te/QT比值分别为(356.2±16.5)ms、(82.5±9.9)ms和(0.232±0.027),与术前相比差异具有统计学意义(t=29.37,15.11,3.929,P<0.05),且与对照组相比差异无统计学意义(P>0.05);Tp-Te≥100 ms和Tp-Te/QT≥0.25的AMI患者更易于发生MAE,差异具有统计学意义(χ2=6.715和4.586,P<0.05)。术前共22例发生MAE,占27.5%,术后5例发生MAE,占6.25%,差异具有统计学意义(χ2=12.88,P<0.05)。结论 QTc、Tp-Te间期和Tp-Te/QT比值可作为一项心电图指标对心肌梗死发生恶性心律失常事件进行判断,Tp-Te间期≥100 ms和Tp-Te/QT比值≥0.25可为MAE的发生做较好的预测。

Abstract：Objective To explore the diagnostic value of Tp-Te interval and Tp-Te/QT ratio for the malignant arrhythmia events of patients with myocardial infarction. Methods 80 patients with AMI received in our hospital from Jan 2011 to Dec 2012 were selected as the observation group, 100 cases of healthy people received in our hospital at the same time were selected as control group, QTe ,Tp-Te interval and Tp-Te/QT ratio in the two groups were compared and analyzed by ECG study,the incidence of MAE in 80 patients with AMI were analyzed by QTc 440 ms,Tp-Te interval 100 ms,Tp-Te/ QT 0.25. SPSS 18.0 software package was used for analysis between the two groups, the measurement data were com- pared using t test,count data were compared using X2 test. Results QTc,Tp-Te interval and Tp-Te/QT ratio in observa- tion group before PCI were （432.3 ± 18.2） ms, （ 107.5-± 12.3 ） ms and （0. 249 ± 0.031 ）, significantly higher the control group [ （352.1 ± 15.5 ） ms, （ 80.4± 9.1 ） ms and （ 0. 228 ± 0. 025 ） 1 , the differences were statistically significant （ t = 31.92,16.98,5. 032 ,P 〈 0.05） ;QTc ,Tp-Te interval and Tp-Te/QT ratio in observation group one week after PCI were （356.2± 16.5 ） ms, （ 82.5 ± 9.9 ） ms and （ 0. 232 ± 0. 027 ）, significantly higher the values before PCI, the differences were statistically significant （ t = 29.37,15.11,3. 929, P 〈 0.05 ） , and there were no significant differences compared with the control group（ P 〉 0.05 ） ;Tp-Te≥ 100 ms and Tp-Te/QT≥0.25 in AMI patients were more prone to MAE ,the differ- ences were statistically significant（ X2 = 6. 715 and 4. 586, P 〈 0.05 ）. The postoperative MAE rate was significantly lower than that of preoperative with statistically significant difference （ 6.25% vs. 27.5%, X2=12.88, P 〈 0.05 ）. Conclu- sion QTc ,Tp-Te interval and Tp-Te/QT ratio can be used as an ECG indicator for malignant arrhythmia events of myo- cardial infarction patients,Tp-Te interval≥100 ms and Tp-Te/QT ratio≥0.25 could be used for forecasting MAE.