QT离散度预测老年急性心肌梗死患者室性心律失常的价值分析

VALUE OF QT DISPERSION IN PREDICTING VENTRICULAR ARRHYTHMIA IN ELDERLY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

目的:探究QT间期离散度(QTd)预测老年急性心肌梗死(AMI)患者发生室性心律失常的临床价值。方法:回顾性分析2017年1月至2018年1月博罗县人民医院收治的150例老年AMI患者的资料,依据患者入院后心律失常发生情况分为恶性室性心律失常组(A组,n=42)、潜在恶性室性心律失常组(B组,n=60)和无室性心律失常组(C组,n=48),分析QTd与老年AMI患者心律失常发生的关系,观察QTd取不同截断值时对心律失常预测的价值。结果:各组间QTd和校正QTd(QTcd)水平相比,差异均有统计学意义(P<0.05)。组间两两比较差异均有统计学意义(P<0.05),且QTd和QTcd水平A组>B组>C组。QTd截断值取60 ms是最佳截断值,对AMI患者心律失常预测的灵敏度、特异度分别为90.51%、83.19%,约登指数为0.7370。结论:老年AMI患者QTd、QTcd越高则室性心律失常发生风险越大,当QTd截断值取60 ms时对老年AMI患者室性心律失常具有较好的预测价值。

Objective:to explore the clinical value of QT interval dispersion(QTd)in predicting ventricular arrhythmia in elderly patients with acute myocardial infarction(AMI).Methods:The clinical data of one hundred and fifty elderly patients with AMI admitted to Boluo County People's Hospital from January 2017 to January 2018 were analyzed retrospectively.Patients were divided into malignant ventricular arrhythmia group(group A,n=42 cases),potential malignant ventricular arrhythmia group(group B,n=60 cases)and non-ventricular arrhythmia group(group C,n=48 cases)according to the occurrence of arrhythmia.The relationship was analyzed between QTd and arrhythmia in elderly patients with AMI,The value of different truncated values of QTd in predicting arrhythmia was observed.Results:There was significant difference for QTd and corrected QTcd among the three groups(P<0.05),with significant difference between every two groups(P<0.05),group A>group B>group C for the levels of QTd and QTcd.The best cut-off value was 60 ms for QTd.The sensitivity and specificity for predicting arrhythmia in patients with AMI were 90.51% and 83.19% respectively.The Yoden index was 0.7370.Conclusion:The higher the level of QTd and QTcd,the higher the risk of ventricular arrhythmia in elderly patients with AMI.When the cut-off value of QTd is 60 ms,it has better predictive value for ventricular arrhythmia in elderly patients with AMI.