Tp－Te间期及Tp－Te／QT比率对心功能不全患者的临床应用价值

The clinical value of Tp-Te and Tp-Te/QT for the patients with heart failure

目的探讨反映心室跨壁复极离散度（TDR）的相关指标T波峰-末间期（Tp－Te）和T波峰-末间期／QT间期比率（Tp－Te／QT）对心功能不全患者的临床意义及应用价值。方法105例心功能不全患者及100例对照组纳入研究。记录所有入选者的体表心电图Tp－Te间期及Tp－Te／QT比率，以及心率、年龄、BNP等相关临床指标。按照纽约心功能分级（NYHA）将病例组分为低危组（NYHAⅠ-Ⅱ）及高危组（NYHAⅢ-Ⅳ），将高危组中治疗后BNP下降≥30％的患者纳入治疗有效组。分别比较心功能不全患者与对照组、心功能不全严重程度不同患者之间，以及高危心功能不全患者治疗前后Tp－Te间期及Tp－Te／QT比率的差异。结果①心功能不全患者与对照组比较，Tp－Te间期及Tp－Te／QT比率均明显增加[Tp－Te（127．15±21．48）ms比（99．85±19．16）ms；Tp－Te／QT（0．33±0．05）比（0．23±0．04），P〈0．05]。②高危心功能不全患者较低危患者的Tp－Te间期及Tp－Te／QT比率明显增大[Tp－Te（135．90±24．91）ms比（119．09±18．45）ms；Tp－Te／QT（0．37±0．07）比（0．27±0．06），P〈0．05]。③高危心功能不全患者治疗后与治疗前比较，Tp－Te间期未见统计学差异[（127．14±15．60）ms比（131．95±18．6）ms，P〉0．05]，而Tp－Te／QT比率有所降低[（0.31±0．06）比（O．37±0．06），P〈0．0530结论Tp－Te间期及Tp－Te／QT比率可作为反映心功能不全患者病情严重程度及治疗效果的临床心电学指标。

Objective To research the clinical value of Tpeak-Tend interval（Tp-Te） and Tpeak-Tend interval/QT interval Tp-Te/QT on the patients with heart failure. Methods 105 cases of heart failure patients and 100 healthy subjects enrolled in the study. Tp-Te and Tp-Te/QT of ECG in all subjects, and other clinical indicators of heart rate, age, BNP were recorded. According to the New York Heart Association classification of cardiac function （NYHA）, the patients were divided into Low-risk Group （NYHA I -II ） and High-risk Groups （NYHA III- IV ）. The patients with BNP decreased by more than 30% after treatment were enrolled in the Therapeutically Effective Group. The differences of Tp-Te, Tp-Te/QT were compared between the Groups. Results （1）Tp-Te and Tp-Te/QT were obviously increased in heart failure patients[Tp-Te（ 127.15±21.48）ms vs （99.85± 19.16）ms, Tp-Te/QT （0.33±0.05） vs （0.23±0.04）, P〈0.05]. （2）Tp-Te and Tp-Te/QT in High-risk Group patients were significantly increased than Low-risk Group[Tp-Te（ 135.90±24.91 ）ms vs （119.09±18.45）ms; Tp- Te/QT （0.37±0.07） vs （0.27±0.06）, P〈0.05]. （3）There was no significant difference of Tp-Te between patients before and after treatment [（127.14±15.60）ms vs （131.95±18.6）ms, P〉0.05]. But Tp-Te/QT before and after treatment was statistically significant[（0.31±0.06） vs （0.37±0.06）, P〈0.05]. Conclusion Tp-Te and Tp-Te/QT are effective electrocardiology-index in evaluating the severity and treatment in patients with heart failure.