疑难病杂志Issue(4)：331-334,4.DOI:10.3969/j.issn.1671-6450.2015.04.001
微伏级 T 波电交替和窦性心率震荡在冠心病患者中的诊断价值
Diagnostic value of microvolt T wave alternans and heart rate turbulencei n patients with coronary heart disease
摘要
Abstract
Objective To investigate the diagnosis value of microvolt T wave alternans ( MTWA) and heart rate tur-bulence (HRT) in the coronary heart disease.Methods From October 2013 to December 2014, 76patients who were sus -pected coronary heart disease and underwent coronary angiography, 24 hour dynamic electrocardiogram examination were en-rolled.Using Baihui dynamic ECG analysis software, 24 h dynamic electrocardiograms were recorded.The normal coronary angiography or coronary artery stenosis <50%were enrolled as control group (30 cases) , coronary angiography revealed coro-nary artery stenosis >75%were enrolled as disease group (46 cases), and further divided into angina subgroup (24 cases) and myocardial infarction subgroup (22 cases).At the same time, according to the degree of coronary artery lesions involve-ment,these patients were divided into single vessel subgroup (16 cases), two vessel subgroup (18 cases) and three vessel subgroup (12 cases), 24 h dynamic electrocardiogram changes, the positive rate of MTWA and HRT were analyzed and com-paredbetweengroups.Results (1)ThepositiverateofMTWAwas41.3%indiseasegroup,whichwashigherthancontrol group’s 6.7%( P <0.05);the positive rate of HRT was 50.0%in disease group, which was higher than that of the control group’s 36.7%( P<0 .05);the positive rate of MTWA combined with HRT was 26.1%in disease group,which was higher than that of control group 3.3%( P <0.05).(2) The positive rate of MTWA was 75.0%in angina subgroup, which was higher than myocardial infarction subgroup’s 4 U.5%(P <0 .05);the positive rate of HRT was 91.6%in angina subgroup, which was higher than the 4.5%of myocardial infarction subgroup ( P <0.05);the positive rate of MTWA combined with HRT was 45.8%in angina subgroup, which was higher than 4.5%of myocardial infarction subgroup ( P <0.05).(3) Sin-gle vessel subgroup , two vessel subgroup, three vessel sub group’s MTWA positive rates were 18.8%, 33.3%, 83.3%, re-spectively;HRT positive rates were 25.0%, 44.4%, 91.7%,respectively , the positive rate of MTWA combined with HRT were 6.2%, 22.2%, 58.3%, respectively, the differences in the 3 subgroups showed significant differences ( P <0.05) . (4) MTWA, HRT and MTWA combined with HRT’ s sensitivity in detection of malignant ventricular arrhythmias in patients with coronary artery disease were respectively 50.0%, 70.0%, 75.0% respectively;specificity was 61.1%, 55.6%, 64. 0% respectively.Conclusion It showed that the MTWA, HRT were good noninvasive electrophysiological indexes for evalua-tion of risk degree in coronary heart disease, combined use of the two indexes can improve the diagnostic value of 24 hour dy-namic electrocardiogram for coronary heart disease;to predict the occurrence of malignant ventricular arrhythmia, the sensitivi-ty and specificity of combined indexes are better than single index.关键词
微伏级T波电交替/窦性心率震荡/冠心病Key words
Microvolt T wave alternans/Heart rate turbulence/Coronary heart disease引用本文复制引用
于敏,黄织春,任润梅,伊雅芳..微伏级 T 波电交替和窦性心率震荡在冠心病患者中的诊断价值[J].疑难病杂志,2015,(4):331-334,4.基金项目
内蒙古自治区自然科学基金 （）
