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目的探讨Tp-Te间期与Tp-Te/QT比值对急性心肌梗死(Acute Myocardial Infarction AMI)患者发生恶性心律失常的判断价值。方法选取2011年1月—2012年12月温州医科大学附属第一医院收治的AMI患者80例作为观察组,选择同期健康体检者100人作为对照组,采集2组研究对象的QTc、Tp-Te间期以及Tp-Te/QT比值进行分析,选择QTc 440 ms、Tp-Te间期100 ms、Tp-Te/QT 0.25为节点,对80例AMI患者中恶性心律失常事件(Malignant arrhythmia events,MAE)的发生情况进行分析。结果观察组术前QTc、Tp-Te间期以及Tp-Te/QT的值分别为(432.3±18.2)ms、(107.5±12.3)ms和(0.249±0.031),均显著高于对照组[(352.1±15.5)ms、(80.4±9.1)ms和(0.228±0.025)],差异具有统计学意义(t=31.92,16.98,5.032,P<0.05);观察组术后1周的QTc、Tp-Te间期以及Tp-Te/QT比值分别为(356.2±16.5)ms、(82.5±9.9)ms和(0.232±0.027),与术前相比差异具有统计学意义(t=29.37,15.11,3.929,P<0.05),且与对照组相比差异无统计学意义(P>0.05);Tp-Te≥100 ms和Tp-Te/QT≥0.25的AMI患者更易于发生MAE,差异具有统计学意义(χ2=6.715和4.586,P<0.05)。术前共22例发生MAE,占27.5%,术后5例发生MAE,占6.25%,差异具有统计学意义(χ2=12.88,P<0.05)。结论 QTc、Tp-Te间期和Tp-Te/QT比值可作为一项心电图指标对心肌梗死发生恶性心律失常事件进行判断,Tp-Te间期≥100 ms和Tp-Te/QT比值≥0.25可为MAE的发生做较好的预测。
Objective To investigate the value of Tp-Te interval and Tp-Te / QT ratio in the determination of malignant arrhythmia in patients with acute myocardial infarction (AMI). Methods Eighty patients with AMI admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2011 to December 2012 were selected as the observation group and 100 healthy subjects were selected as the control group. QTc, Tp-Te Interval and Tp-Te / QT ratio were analyzed. The QTc 440 ms, Tp-Te interval 100 ms and Tp-Te / QT 0.25 were used as nodes. The incidence of malignant arrhythmia events ) Of the occurrence of the situation for analysis. Results The values of QTc, Tp-Te and Tp-Te / QT in the observation group were (432.3 ± 18.2) ms and (107.5 ± 12.3) ms and (0.249 ± 0.031) The difference was statistically significant (t = 31.92, 16.98, 5.032, P <0.05). The QTc, Tp-1, Te interval and Tp-Te / QT ratio were (356.2 ± 16.5) ms, (82.5 ± 9.9) ms and (0.232 ± 0.027) respectively, with statistical significance compared with those before operation (t = 29.37,15.11,3.929 , P <0.05), and there was no significant difference compared with the control group (P> 0.05); MAE was more likely to occur in AMI patients with Tp-Te≥100 ms and Tp-Te / QT≥0.25, the difference was statistically significant (χ2 = 6.715 and 4.586, P <0.05). Preoperative MAE occurred in 22 cases, accounting for 27.5%. MAE occurred in 5 cases (6.25%) after operation. The difference was statistically significant (χ2 = 12.88, P <0.05). Conclusions QTc, Tp-Te interval and Tp-Te / QT ratio can be used as an electrocardiogram indicator to judge the incidence of malignant arrhythmia in myocardial infarction. The Tp-Te interval ≥100 ms and the Tp-Te / QT ratio ≥0.25 Make a good prediction for the occurrence of MAE.