文章摘要
赵淑琴,黄晓青,朱莉,张炜,任莉娜,齐国先.急性心肌梗死患者T波电交替及窦性心率震荡的特征及临床意义[J].中国临床保健杂志,2016,(3):273-275.
急性心肌梗死患者T波电交替及窦性心率震荡的特征及临床意义
The clinical manifestation and characteristic of ambulatory ecg-based t-wave alternans and heart rate turbulence in patients with acute myocardial infarction
投稿时间:2016-04-10  
DOI:10.3969/J.issn.1672-6790.2016.03.016
中文关键词: 心肌梗死  心律失常  心震荡  猝死,心脏  心电描记术,便携式
英文关键词: Myocardial infarction  Arrhythmia  Commotio cordis  Death,sudden,cardiac  Electrocardiography,ambulatory〖FL
基金项目:
作者单位
赵淑琴 中国医学科学院阜外医院,北京 100037 
黄晓青 中国医学科学院阜外医院,北京 100037 
朱莉 中国医学科学院阜外医院,北京 100037 
张炜 中国医学科学院阜外医院,北京 100037 
任莉娜 中国医科大学附属第一医院老年心内科 
齐国先 中国医科大学附属第一医院老年心内科 
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中文摘要:
      目的 研究心肌梗死及心肌梗死合并糖尿病患者T波电交替(TWA)和窦性心率震荡(HRT)的特征及其临床意义。方法 选取149例患者,其中心肌梗死 (MI) 57例,心肌梗死合并糖尿病(MI+DM)52例,对照组40例。给予动态心电图检查,应用时域分析法和渐量修正技术分析TWA值,以及HRT的两个参数:震荡初始(TO)、震荡斜率(TS)。分析:①三组患者TWA、TO及TS均值的比较;TWA阳性率的比较;②心肌梗死患者复合心脏事件(室速/室颤、心脏性死亡)的发生率。结果 ①MI组和MI+DM组患者TWA均值及TWA的阳性率明显高于对照组 (P<0.01),MI+DM组患者TWA的阳性率高于MI组,但TWA均值差异无统计学意义;②MI+DM组室速/室颤发生率高于MI组(P<0.05),MI+DM组心脏性死亡患者2例;③心肌梗死患者的震荡初始(TO)较对照组增加(P<0.05),而震荡斜率(TS)则减低(P<0.01)。结论 心肌梗死患者TWA值增加,HRT的两个参数-TS减弱而TO增加。TWA和HRT可能为评价心肌梗死患者发生恶性心律失常及心脏性猝死的有用指标。
英文摘要:
      Objective To explored the characteristic and clinical manifestation in patients with ischemic heart diseases according to T-wave alternans (TWA) using modified moving average (MMA) method and heart rate turbulence (HRT).Methods A analysis of 149 patients who underwent MMA-based TWA and HRT divided into 3 groups:group-C of 40 controls,group-MI of 57 patients with myocardial infarction,52 patients with MI with diabetes(group-MI+DM).The TWA was calculated automatically using time-domain modified moving average method.Group-MI was divided into two subgroups:HRT abnormal subgroup and HRT normal subgroup and the accidence of cardiac events of inhospitalization was observed in the two subgroups.Result The TWA value was differ significantly between MI and controls (P<0.001).Among MI with diabetes,the accidence of ventricular tachyarrhythmia is higher than MI.Impaired HRT were observed most frequently in group- MI (P<0.05),especially the decrease of the HRT onset slope (TS) (P<0.05).Conclusion T-wave alternans is elevated in patients following myocardial infarction.Weaken HRT,increased To and decreased TS were observed in myocardial infarction patients.TWA and HRT may be independent predictors of cardiac and arrhythmic death in myocardial infarction patients.
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