20例扩张型心肌病患者的T波峰-末间期特点

目的探讨作为反映心室复极离散的指标，T波峰-末间期（Tpeak-Tendinterval，Tp-e）在扩张型心肌病患者中的特点。方法收集20例于2003。2010年人住本院的已确诊的原发性扩张型心肌病患者及正常对照19例进行回顾性分析。测量39份体表心电图的Tp-e和QT间期离散度（dispersion of QTinterval，QTd），并计算校正后的Tp-e平均值、Tp-e最大值，以及vl、V5、Ⅱ导联的Tp-e，分别记为Tp-e-AVEC、Tp-e-MAXC、Tp-e-V1C、Tp-e-V5C、Tp-e-ⅡC。比较上述各参数在扩张型心肌病与正常人之间的差异。结果经比较发现扩张型心肌病组Tp-e-AVEC（95．7±14．3vs582．7±10．0，P〈0．05）、Tp-e-MAXC（148．5±28．8vs119．2±11．6，P〈0．05）、Tp-e-ⅡC（90．8±19．7vs72．5±13．5，P〈0．05）、QTd（53．3±19．8VS39．7±17．0，P〈0．05）较正常对照组明显延长，而两组Tp-e-VIC（96．6±19．1vs87．2±21．2，P〉0．05）、Tp-e-V5C（99．5＋25．1vs86．9±12．7，P〉0．05）未见明显差异。结论（1）扩张型心肌病患者Tp-e较正常人明显延长，提示Tp-e可能可以作为该类患者预后评价的无创性指标之一。（2）与正常对照组比较，发现扩张型心肌病组的Tp-e-AVEC、Tp-e-MAXC和Tp-e-ⅡC明显延长，而Tp-e-VIC、Tp-e-V5C在两组间未见明显差异，间接提示Tp-e反映心室整体复极离散度的可能性大。（3）关于Tp-e测量的方法学建议选用Tp-e-AVE、Tp-e-MAX和Tp-e-II，可能更适用于评价该类患者的心室复极离散。

T peak- T end interval of 20 cases of dilated cardiomyopathy

Objective To investigate the characteristics of T peak-T end interval （Tp-e） in patients with dilated cardiomyopathy as indicators of ventricular repolarization dispersion. Methods Twenty cases of confirmed idiopathic dilated cardiomyopathy admitted in our hospital during 2003 and 2010 and 19 cases of normal controls were retrospectively analyzed. Tp-e and dispersion of QT interval （QTd） of 39 surface ECG were measured and average and maximum of corrected Tp-e and V1, V5 and Ⅱ leads Tp-e were calculated and denoted as TP-e-AVEC TP-e MAXC, TP-e-VIU, TP-e-V5C and Tp-E- ⅡC. Differences in the parameters between the dilated cardiomyopathy patients and normal controls were compared. Results The comparison showed that Tp-e-AVEC （95.7±14.3 vs 82.7±10.0, P 〈 0.05）, Tp-e-MAXC （148.5±28.8 vs 119.2±11.6, P 〈 0.05）, Tp-e-ⅡC （90.8±19.7 vs 72.5±13.5, P 〈 0.05） and QTd （53.3±19.8 vs 39.7±17.0, P 〈 0.05） of the dilated cardiomyopathy group was significantly longer compared with the normal control group, while Tp-e-VIC （96.6±19.1 vs 87.2±21.2, P 〉 0.05） and Tp-e-V5C （99.5±25.1 vs 86.9±12.7, P 〉 0.05） showed no significant differences between the two groups. Conclusion （1） Tp-e of patients with dilated cardiomyopathy is significantly longer than the normal controls, it＇suggesting that Tp-e can be used as one of the indicators of noninvasive prognostic evaluation of these patients. （2） Compared with the normal control group, Tp-e- AVEC, Tp-e-MAXC and Tp-e-Ⅱ C of dilated cardiomyopathy group are significantly longer, while Tp-e-V1C and Tp-e-V5C show no significant differences between the groups, which indirectly suggest the possibility of Tp-e as indicators of ventricular overall repolarization dispersion. （3） Regarding the method of measurement of Tp-e, the use of Tp,e-AVE, TP-e-max and Tp-e- Ⅱ is recommended because they may be more suitable for the evaluation of ventricular repolarization.