室性期前收缩患者心室复极储备功能评价

The repolarization reserve function of patients withventricular premature beat

目的探讨QTc间期、QTd、Tp-ec间期、Tp-ed、Tp-e/QT比值对室性期前收缩患者复极储备功能的评价作用。方法入选窦性心律合并室性期前收缩患者229例,根据室性期前收缩后窦性心动周期中QT间期的恢复,将恢复异常者纳入观察组,将恢复正常者纳入对照组,比较组间QTc间期、QTd、Tp-ec间期、Tp-ed、室速发作的差异性;比较组内不同心率下QTc间期的变化;评价QTc间期、QTd、Tp-ec间期、Tp-ed、Tp-e/QT比值对室性期前收缩患者心室复极异常的诊断价值。结果观察组与对照组间性别、年龄、QTd无统计学差异,QTc间期(p=0.010<0.05)、Tp-ec间期(p=0.000<0.05)、Tp-ed(p=0.03<0.05)有统计学差异,室速发作(17例、5例),发生率(p=0.003<0.05)有统计学差异;观察组、对照组不同心率下QTc间期变化有统计学差异;QTc、Tp-ec、Tp-e/QT比值对复极异常有诊断价值(p<0.05),QTd、TP-ed、对复极异常无诊断价值(p>0.05),各指标诊断复极储备异常的最佳界值如下:男性QTc≥458ms,女性QTc≥469ms,Tp-ec≥95ms,TP-e/QT比值≥0.22。结论 QTc、QTd、TP-e、TP-ed、TP-e/QT比值是适用于评价室性期前收缩患者心室复极储备功能异常的无创性指标,结合室性期前收缩后QT间期的动态性变化可提高诊断的准确度。对SCD高危人群的早期诊断及预防性治疗有指导作用。

Objective To investigate the value of corrected QT interval、QTd、Tp-ec interval、Tp-ed、Tp-e/QT ratio for The repolarization reserve founction in patients with ventricular premature beat. Methods 229 cases of sinus rhythm with ventricular premature beat were included, according to the recovery of QT interval in sinus cycle length behind ventricular premature beat, whose QT interval recovery was abnormal would be brought into the observation group, and the normal brought into the control group, To compare the differences of corrected QT interval、QTd、Tp-ec interval、Tp-ed、and incidence of ventricular tachycardia between two groups. Evaluating the diagnosis value of corrected QT interval、QTd、Tp-ec interval、Tp-ed、Tp-e/QTratio in patients with ventricular premature beat. Results Between observation group and control group, gender, age, QTd had no statistical differences,corrected QT interval,Tp-ec interval, Tp-ed,and incidence of ventricular tachycardia had statistical differences. Under different heart rate,the change of corrected QT interval had statistical differences. Corrected QT interval,Tp-ec interval, Tp-e/QT ratio has diagnostic value to the repolarization reserve dysfunction, QTd has no diagnostic value.The best diagnosis boundary value of each index to repolarization reserve dysfunction is： male QTc ≥458 ms and female QTc ≥ 469 ms, Tp-ec ≥ 95 ms, TP-e/QT ratio ≥ 0.22. Conclusions QTc, QTd, Tp-ec, Tp-ed, TP-e/QT ratio as noninvasive indexes is applicable to evaluate the repolarization reserve function 0f patients with ventricular premature beat. And they can improve the accuracy of diagnosis if combined with the dynamic changing of QT interval after with ventricular premature beat.it has diagnosis value and guiding effect for SCD.