额面QRS-T夹角及Tp-e/QTc比值与冠状动脉慢血流现象的相关性研究

  目的  探讨心电图额面QRS-T夹角和Tp-e/QTc比值与冠状动脉慢血流现象（CSFP）的关系及预测价值。  方法  选取昆明医科大学第二附属医院2019年9月至2021年12月行冠脉造影术检查确诊为CSFP的患者73例为观察组，随机选取同期67例冠脉血流正常患者作为对照组。比较两组患者临床资料、心电图相关参数及实验室检查指标，采用多因素Logistic回归分析影响CSFP发生的危险因素，绘制受试者工作特征（ROC）曲线，评估额面QRS-T夹角及Tp-e/QTc比值对CSFP的预测作用。  结果  与对照组比较，额面QRS-T 夹角、Tp-e间期、Tp-e/QT比值、Tp-e/QTc比值、体重指数（BMI）、红细胞（RBC）、血红蛋白（Hb）、红细胞比容（HCT）、肌酐（Cr）均较高，差异有统计学意义（P < 0.05）。多因素Logistic回归分析结果显示，BMI（OR = 1.137，P = 0.014）、Cr（OR = 1.048，P = 0.004）额面QRS-T夹角（OR = 1.020，P = 0.003）、Tp-e/QTc 4分位（IQR）等级（OR = 1.960，P < 0.001）是影响CSFP的独立相关因素。ROC曲线分析显示，额面 QRS-T夹角对CSFP的最佳截断值为45.5度，曲线下面积为 0.706，灵敏度和特异度分别为 56.2%和80.1%；Tp-Te/QTc 比值的CSFP的最佳截断值为0.22，曲线下面积为 0.68，灵敏度和特异度分别为 66%和69%。  结论  额面 QRS-T夹角和Tp-e/QTc比值与CSFP存在相关性，对CSFP具有一定的预测价值。

Correlation of Frontal Planar QRS-T and Tp-e/QTc Ratio with Coronary Slow Flow Phenomenon

  Objective  To investigate the relationship between electrocardiographic frontal QRS-T angle, Tp-e/QTc ratio, and coronary slow flow phenomenon （CSFP） and evaluate the predictive value of frontal QRS-T angle and Tp-e/QTc ratio.   Methods  Seventy-three patients with CSFP diagnosed by coronary angiography in our hospital from September 2019 to December 2021 were selected as the study group, and 67 patients with the normal coronary flow in the same period were randomly selected as the control group. The clinical data, related ECG parameters, and laboratory indexes of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the risk factors affecting the risk factors of CSFP. The receiver operating characteristic （ROC） curve was drawn to explore the predictive value of frontal QRS-T angle and Tp-e/QTc ratio.   Results  Compared with the control group, frontal QRS-T angle, Tp-e interval, Tp-e / Qt ratio, Tp-e / QTc ratio, BMI, Cr, RBC, Hb, and HCT were higher, and the two groups were statistically different （all P < 0.05）. In?the multivariate Logistic regression analysis show that BMI （OR = 1.137, P = 0.014）、Cr （OR = 1.048, P = 0.004）, frontal QRS-T angle （OR = 1.020, P = 0.003）, Tp-e/QTc （IQR） grade OR = 1.960, P < 0.001） were independent risk factors for CSFP. ROC curve analysis displayed that the diagnostic cut-off value of frontal QRS-T angle was 45.5 degree, The area under the curve was 0.706, and the sensitivity and specificity were 56.2% and 80.1%, respectively; the diagnostic cut-off value of CSFP for Tp-Te/QTc ratio was 0.22, the area under the curve was 0.68, and the sensitivity and specificity were 66% and 66%, respectively. 69%.   Conclusion  Frontal QRS-T angle and Tp-e/QTc ratio were associated with CSFP, which had a certain potential predictive value for the occurrence of CSFP.