T波电交替、心率变异联合检测对急性心肌梗死患者恶性心律失常预测评估的作用

The value of TWA and HRV in predicting malignant arrhythmia in AMI patients

目的探讨研究T波电交替(T Wave Alternans,TWA)、心率变异联合检测对急性心肌梗死患者恶性心律失常预测评估的作用。方法选取120例急性心肌梗死患者,依据有无恶性心律失常分为恶性心律失常组(A组,36例)和无恶性心律失常组(B组,84例),对比两组T波电交替和心率变异结果,并分析其对恶性心律失常的评估作用。结果两组V1导联处TWAmax差异具有统计学意义(P<0.05),且心率变异指标SDNN、SDANN差异均具有统计学意义(P均<0.05);当TWA≥25 u V或SDNN≤60 ms时,T波电交替联合心率变异对急性心肌梗死患者恶性心律失常的灵敏度、特异度分别为70.68%、61.71%,当TWA≥25 u V或SDANN≤50 ms时各指标分别为75.08%、55.07%。结论采用T波电交替、心率变异联合检测对急性心肌梗死患者恶性心律失常具有重要的预测评估价值,值得推广使用。

Objective To explore the role of prediction and evaluation of T wave alternation（ TWA） and heart rate variability（ HRV） on malignant arrhythmia in patients with acute myocardial infarction（ AMI）. Methods One hundred and twenty cases of acute myocardial infarction from Aug 2012 to Aug 2015 were divided into the malignant arrhythmia group（ 36 cases,Group A） and no malignant arrhythmia group（ 84 cases,Group B）,Compared the TWA alternation and HRV results of the two groups. Results The difference of TWAmax in V1 lead of the two groups was statistically significant（P〈0. 05）,and the differences of heart rate variability indexes SDNN and SDANN were statistically significant（ both Ps 0. 05）. When TWA was more than or equal to 25 u V or SDNN less than or equal to 60 ms,the sensitivity and specificity,of T wave alternation and heart rate variability on malignant arrhythmia in patients with acute myocardial infarction were respectively 70. 68 % 、61. 71%,and when TWA was more than or equal to 25 u V or SDANN less than or equal to 50 ms,all indexes were respectively 75. 08% 、55. 07%. Conclusion The combined detection of T wave alternation and heart rate variability in patients with acute myocardial infarction malignant heart rate disorders has important predictive value,which is worthy of promotion.