复极离散度指标预测慢性心力衰竭患者发生恶性室性心律失常的临床价值探讨

The Clinical Value of Repolarization Dispersion Index in Predicting Malignant Ventricular Arrhythmia in Patients with Chronic Heart Failure

目的:探讨心电图相关复极离散度指标对慢性心力衰竭患者发生恶性室性心律失常的预测价值。方法:选取2022年6月-2023年2月于徐州市中医院治疗的68例慢性心衰患者作为研究对象,根据动态心电图结果,分为恶性心律失常组34例,非恶性心律失常组34例。分析两组间心电图指标QT间期、心率校正QT间期、Tp-Te间期、Tp-Te间期离散度、Tp-Te/QT是否存在差异,这些指标对恶性室性心律失常的发生是否具有预测价值。结果:两组间比较,QT间期、心率校正QT间期无显著差异(P>0.05);Tp-Te间期、Tp-Te间期离散度、Tp-Te/QT差异具有统计学意义,其中Tp-Te间期(P<0.05),Tp-Te间期离散度、Tp-Te/QT(P<0.001)。绘制ROC曲线分析得出Tp-Te间期离散度对恶性室性心律失常的预测价值最高,AUC、最佳临界值、灵敏度、特异度、95%CI分别为0.947、38ms、88.2%、94.1%、0.891~1.000,Tp-Te/QT次之,QT、QTc、Tp-Te三者预测价值较低。结论:心电图相关复极离散度指标中,Tp-Te间期离散度是慢性心力衰竭合并恶性室性心律失常的最佳预测指标,Tp-Te间期、Tp-Te/QT也可为诊断提供一定价值。

Objective:To investigate the predictive value of ECG repolarization dispersion index for malignant ventricular arrhythmias in patients with chronic heart failure.Methods:68 patients with chronic heart failure treated in Xuzhou Hospital of Traditional Chinese Medicine from June 2022 to February 2023 were selected as research objects.According to the results of dynamic electrocardiogram,they were divided into malignant arrhythmia group(34 cases)and non-malignant arrhythmia group(34 cases).To analyze whether there were differences in ECG indicators QT interval,heart rate correction QT interval,Tp-Te interval,Tp-Te interval dispersion,and Tp-Te/QT between the two groups,and whether these indicators had predictive value for the occurrence of malignant ventricular arrhythmias.Results:There were no significant differences in QT interval and heart rate correction QT interval between the two groups(P>0.05).The differences of Tp-Te interval,Tp-Te interval dispersion and Tp-Te/QT were statistically significant,including Tp-Te interval dispersion(P<0.05),Tp-Te interval dispersion and Tp-Te/QT(P<0.001).ROC curve analysis showed that Tp-Te interval dispersion had the highest predictive value for malignant ventricular arrhythmias,AUC,optimal critical value,sensitivity,specificity,95%CI were 0.947,38ms,88.2%,94.1%,0.891~1.000;followed by Tp-Te/QT;QT,QTc and Tp-Te have low predictive value.Conclusion:Among ECG repolarization dispersion indexes,Tp-Te interval dispersion is the best predictor of chronic heart failure complicated with malignant ventricular arrhythmia,and Tp-Te interval and Tp-Te/QT can also provide certain value for diagnosis.