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目的观察微伏级T波电交替、平板运动试验结果、经心率校正的QT间期(QTc)和室性心律失常发生的关系,为临床判断患者病情和预后提供参考。方法选择我院内科2011年8月至2012年7月行平板运动试验的患者260例,其中男性140例,女性120例,采用GE公司提供的MarquetteT波电交替(TWA)分析程序,进行标准时域运动试验,最后对每例患者的性别、年龄、TET、MTWA、QTC等指标进行分析。结果 260例患者中TET阳性86例,TET阴性174例,TWA阳性42例,TWA阴性219例,所有病例中发生室性心律失常59例,QTc延长142例,双水平logistic回归分析显示TET阳性者发生室性心律失常的风险增加2.37倍(p=0.018,95%可信区间1.163~4.841);MTWA阳性者发生室性心律失常的风险增加7.213倍(p=0.000,95%可信区间3.178~16.372);男性较女性更易出现室性心律失常(OR值2.239,p=0.020,95%可信区间1.135~4.418)。结论 TET和MTWA阳性者发生室性心律失常的风险显著增加,男性患者更容易发生室性心律失常,临床上对怀疑有冠心病的男性患者应该积极进行TET和MTWA检测,以尽早发现高危患者并给予相应的干预措施。
Objective To observe the relationship between T-wave alternating microvolt level, treadmill exercise test, QTc and ventricular arrhythmia, and to provide reference for clinical judgment of patients’ condition and prognosis. Methods 260 cases of treadmill exercise test in our hospital from August 2011 to July 2012 were selected, including 140 males and 120 females. The MarquetteT Alternating Current (TWA) analysis program provided by GE Company was used to perform standard time domain Exercise test, and finally analyze the gender, age, TET, MTWA, QTC and other indicators of each patient. Results Among 260 patients, TET was positive in 86 cases, TET negative in 174 cases, TWA positive in 42 cases and TWA negative in 219 cases. In all cases, 59 cases had ventricular arrhythmia and QTc prolonged in 142 cases. Bilevel logistic regression analysis showed TET positive The risk of developing ventricular arrhythmias increased by 2.37-fold (p = 0.018, 95% confidence interval, 1.163-4.841); the risk of developing ventricular arrhythmias increased by 7.213-fold (p = 0.000, 95% confidence interval, 3.178 ~ 16.372). Men were more likely to have ventricular arrhythmias than women (odds ratio 2.239, p = 0.020, 95% confidence interval 1.135-4.418). Conclusions The risk of ventricular arrhythmia in patients with positive TET and MTWA is significantly increased. Men are more likely to have ventricular arrhythmias. Men with coronary heart disease should be tested positively by TET and MTWA in order to detect high risk patients as early as possible Give the appropriate intervention.