移行区指数在主动脉窦起源室性心律失常的诊断价值研究

The diagnosis value of transition zone index in aortic coronary cusp ventricular arrhythmias patients

目的探讨移行区指数诊断主动脉冲窦起源室性心律失常的价值。方法纳入自2014年3月致2017年3月经射频消融术证实的右室流出道和主动脉窦起源的室性心律失常患者54例。根据起源不同分为右室流出道组和主动脉窦组。所有患者在行射频消融术前常规行体表心电图检查,计算移行区指数;当移行区指数<0时诊断为主动脉窦起源;≥0时,诊断为右室流出道起源。以射频消融结果为金标准,计算移行区指数诊断主动脉起源室性心律失常的敏感度、特异度及ROC曲线下面积。结果两组患者在年龄分布及性别组成上差异无统计学意义(P>0.05);在时限指数、振幅指数、移行区指数上差异均有统计学意义(P<0.05)。应用移行区指数诊断主动脉窦起源室性心律失常的敏感度(SEN)为81.2500%、特异度(SPE)为93.75%。ROC曲线下面积(AUC)为0.9017。结论移行区指数主动脉窦起源室性心律失常有很高的诊断价值,可用于体表心电图诊断主动脉起源的室性心律失常。

Objective: To investigate the value of transitional zone index( TZI) in the diagnosis of ventricular arrhythmias originating from aortic coronary cusp. Method: From March 2014 to 2017,54 patients with ventricular arrhythmias originating from the right ventricular outflow tract( RAOT-VA) and aortic coronary cusp( ACC-VA) were confirmed by radiofrequency ablation; they were divided into different groups according to their origins. All the patients examined the electrocardiogram and calculated TZI. When TZI,the diagnosis of ACC-VA were occurred when TZI < 0,and the diagnosis of RAOT-VA were occurred When T≥0. The radiofrequency ablation results were the gold standard,the sensitivity,specificity,and area under the ROC curve( AUC) of the TZI were calculated. Result: There was no significant difference in age distribution and sex composition between the two groups( P > 0. 05). There were significant differences in time lag index,amplitude index and transitional zone index( P < 0. 05). The sensitivity( SEN) was 81. 25% and the specificity( SPE) was93. 75%. The area under the ROC curve( AUC) was 0. 9017. Conclusion: There is a high diagnostic value for transitional zone index in the diagnosis of aortic coronary cusp ventricular arrhythmia,and it can be used for the diagnosis of aortic coronary cusp ventricular arrhythmias by electrocardiography.