尖端扭转型室性心动过速与TP—TE时间及Q—T间期比值关系的研究

目的探讨长Q—T间期患者T波峰末时间（TP-TE时间）、TP-TE／Q—T与尖端扭转型室性心动过速（TdP）发生的相关性。方法选择长Q—T间期患者29例，将其分为伴TdP组（发作期或稳定期）和不伴TdP组两组，通过常规心电图和动态心电图分析测量并比较Q—T间期、校正的Q—T间期（Q—Tc间期）、TP-TE时间和TP-TE／Q—Tc结果伴TdP组稳定期患者TP-TE时间、TP—TE／Q—T（14157±37．33ms、0．27±0．05）和发作期（154．29±42ms、0．29±0．06）均较不伴TdP组（97．60±5．51ms、0．19±0．13）延长或增大。差异均有统计学意义（均P〈0．05）；在预测TdP发生风险时，伴TdP组稳定期和发作期TP-TE时间、TP-TE／Q—T均较Q—T间期更敏感（Wald值分别为1247、15．77和5．77、6．23），差异均有统计学意义（P〈O．05）。结论TP-TE时间TP-TE／Q—T比值有助于预测长Q—T间期患者发生TdP的风险。

The Relation of Tpeak-end and QT Interval to Torsade de Pointes in Patients with Long QT Syndrome

Objective To evaluate the relation of Tpeak-end interval （Tp-e） and Yp-e/QT to Torsade de Pointes （TdP） in patients with long QT syndrome （LQTS）. Methods 29 patients with LQTS were divided into groups with and without TdP. QT interval, corrected QT interval （QTc）, Tp-e and Tp-e/QT were measured on surface electrocardiogram and ambulatory electrocardiography and compared between different groups. Results Tp-e interval and Tp-e/QT were significantly larger in patients with previous TdP （ 141.57 ± 37.33ms, 0.27± 0.05 ）and onset of TdP （ 154.29 ± 42ms, 0.29 ± 0.06 ）than those without TdP （ 97.60 ±5.51ms, 0.19 ±0.13, （P〈0.05）. Tp-e interval and Tp-e/QT were more sensitive than QT interval in predicting the risk of TdP in patients with previous TdP and onset of TdP （Wald：12.47, 15.77 and 5.77, 6.23, respectively, P〈0.05）. Conclusion Tp-e interval and Tp-e/QT may be helpful to predict the risk of TdP in LQTS patients.