T波复杂性比率对急性非ST段抬高型心肌梗死的诊断价值

目的 探讨T波复杂性比率在急性非ST段抬高型心肌梗死(NSTEMI)患者中的诊断价值.方法 回顾性分析436例急性冠脉综合征患者的临床资料,所有患者入院后立即行12导联Holter检查,通过对12导联心电图做主成分分析并计算T波复杂性比率.临床结果通过病历记录获得.采用多因素回归分析对NSTEMI和住院期间主要不良心血管事件(MACE)的影响因素进行分析.结果 T波复杂性比率升高是NSTEMI(OR=2.248,95％CI 1.549～3.263,P＜0.001)和住院期间MACE(OR =3.037,95％CI 1.886～4.890,P＜0.001)的预测因子,进行ROC分析,AUC分别为0.715和0.770.结论 测量体表12导联心电图的总体T波复杂性比率可以发现和定量NSTEMI患者非局限性的心肌损伤,并给早期冠心病胸痛患者的评估带来了潜在获益.

Ventricular repolarization dispersion for detection of non-ST elevation myocardial infarction

Objective To explore the relationship between T-wave complexity ratio and non-ST-segment elevation myocardial infarction(NSTEMI).Methods A total of 436 patients with acute coronary syndrome(ACS) were retrospectively analyzed.All the patients admitted to hospital after immediate detection of 12-lead Holter ECGs.T-wave complexity ratio was quantified using principal component analysis of the 12-lead ECG.Clinical outcomes were obtained from hospital records.Results An increased T-wave complexity ratio on the presenting ECG was associated with NSTEMI(OR=2.248,95％CI 1.549-3.263,P ＜0.001) and in-hospital MACE(OR=3.037,95％CI 1.886-4.890,P ＜0.001).The receiver-operating characteristic curve (ROC) analysis for T-wave complexity ratio in predicting NSTEMI and MACE showed area under the curve was 0.715 and 0.770.Conclusions T-wave complexity ratio on the presenting 12-lead ECG correlates with myocardial injury and can discriminate NSTEMI cases very early during evaluation.