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目的探讨QTc间期、QTd、Tp-ec间期、Tp-ed、Tp-e/QT比值对室性期前收缩患者复极储备功能的评价作用。方法入选窦性心律合并室性期前收缩患者229例,根据室性期前收缩后窦性心动周期中QT间期的恢复,将恢复异常者纳入观察组,将恢复正常者纳入对照组,比较组间QTc间期、QTd、Tp-ec间期、Tp-ed、室速发作的差异性;比较组内不同心率下QTc间期的变化;评价QTc间期、QTd、Tp-ec间期、Tp-ed、Tp-e/QT比值对室性期前收缩患者心室复极异常的诊断价值。结果观察组与对照组间性别、年龄、QTd无统计学差异,QTc间期(p=0.010<0.05)、Tp-ec间期(p=0.000<0.05)、Tp-ed(p=0.03<0.05)有统计学差异,室速发作(17例、5例),发生率(p=0.003<0.05)有统计学差异;观察组、对照组不同心率下QTc间期变化有统计学差异;QTc、Tp-ec、Tp-e/QT比值对复极异常有诊断价值(p<0.05),QTd、TP-ed、对复极异常无诊断价值(p>0.05),各指标诊断复极储备异常的最佳界值如下:男性QTc≥458ms,女性QTc≥469ms,Tp-ec≥95ms,TP-e/QT比值≥0.22。结论 QTc、QTd、TP-e、TP-ed、TP-e/QT比值是适用于评价室性期前收缩患者心室复极储备功能异常的无创性指标,结合室性期前收缩后QT间期的动态性变化可提高诊断的准确度。对SCD高危人群的早期诊断及预防性治疗有指导作用。
Objective To investigate the QTc interval, QTd, Tp-ec interval, Tp-ed, Tp-e / QT ratio in patients with premature ventricular repolarization evaluation of repolarization. Methods A total of 229 patients with sinus rhythm and ventricular premature ventricular contractions were enrolled. According to the recovery of QT during sinus rhythm of ventricular systole, the patients with abnormal recovery were included in the observation group, and those who returned to normal were included in the control group. The QTc interval, QTd, Tp-ec interval, Tp-ed, and VT episode were compared among groups. QTc interval, QTd, Tp-ec interval, Diagnostic value of Tp-ed, Tp-e / QT ratio in ventricular repolarization abnormalities in ventricular premature contractions. Results There was no significant difference in sex, age and QTd between the observation group and the control group. There were no significant differences in QTc interval (p = 0.010 <0.05), Tp-ec interval ) Had statistical difference (P = 0.003 <0.05) .There were significant differences in QTc interval between observation group and control group under different heart rates.QTc, The values of Tp-ec and Tp-e / QT had diagnostic value for repolarization abnormality (p <0.05), QTd and TP-ed, no diagnostic value for repolarization abnormality (p> 0.05) The best cutoffs were as follows: male QTc≥458ms, female QTc≥469ms, Tp-ec≥95ms, TP-e / QT ratio≥0.22. Conclusion The QTc, QTd, TP-e, TP-ed and TP-e / QT ratios are useful noninvasive markers for evaluating ventricular repolarization reserve dysfunction in patients with premature ventricular contraction. Combined with the QT interval The dynamic changes can improve the diagnostic accuracy. It can guide the early diagnosis and prophylactic treatment of high risk population of SCD.