急性心肌梗死病人T波交替变异性与心功能的关系

目的研究心肌梗死（AMI）病人T波交替变异性（TWA）与心脏功能及其他因素的关系。方法对41名AMI病人进行TWA导联数目,左室射血功能（LVEF）,磷酸肌酸激酶心肌同工酶（CK-MB）检测,同时对临床上恶性室性心律失常（室速、室颤）的发生进行观察。根据LVEF将病人分为二组;LVEF〈50%,（A组）和LVEF〉≥50%（B组）,比较二组各指标的差异。结果二组病人在LVEF有显著差异的情况下,A组的TWA,TWA导联数目,CK-MB峰值及达到CK-MB峰值的时间均显著高于B组,同时临床上恶性心律失常事件的发生率A组也显著高于B组。结论AMI病人的TWA与LVEF及CK-MB的释放量有密切关系,TWA和LVEF均为预测室性心律失常的有力因子,表明AMI病人的LVEF越低,易形成TWA,引发恶性心律失常。

Study of the relation between T-wave alternans and cardiac functioninactute myocardial

Objective To study the relation between the T-wave altemans （TWA） and cardiac function and other factors in acute myocardial infarction （AMI）. Methods Depending on the left ventricular ejection fraction （LVEF）, 71 patients with AMI were divided into two groups： group A （LVEF〈50%） and group B （LVEF〉 50%） and the TWA,number of TWA lead,creatine kinase isozyme （CK-MB） and ventricular arrhythmic events （VAE） of each patient were determined and compared. Results There were significant difference in LVEF between the two groups （43.1 ± 5.6% vs 63.1 ± 8.2%,P〈0.05）.The numbers of TWA lead,TWA,peak values of CK-MB and time to peak values of CK-MB in group A were significantly higher than those in group B （3.5 ±3.7 vs 1.7 ± 2.7;11.9 ± 9.2 vs 7.5 ± 7.6;120.8 ± 94.4IU/ml vs 65.9 ± 36.91U/ml;17.3 ±7.5h vs 12.6±3.3h,P〈0.05 correspondingly）. The rate of VAE in group A was also higher than that in group B （24.1% vs 7.1%,P〈0.05）. Conclusion The TWA was closely associated with cardiac function （LVEF） and release of CK-MB. The TWA and LVEF both have predictive value for the VAE in AMI.