JTp间期及TpTe间期对室性心律失常的预测价值

目的研究体表心电图J-T波峰间期(JTp间期)及T波顶峰后宽度(TpTe间期)对室性心律失常的发生是否有预测价值。方法在289例入选心脏病病例中,将有频发室性早搏(VPB≥30次/小时)、室性心动过速(VT)和心室颤动(VF)者131例,分设为VPB组(n=69)和VT+VF组(n=62)。并在其余158例入选病例中选择未发现明显室性心律失常者(VPB<5次/小时)60例设为疾病对照组。另设正常对照组(n=60)。对各组JTp、校正的JTp(JTpc)、TpTe及校正的TpTe(TpTec)间期进行组间比较。将JTp及JTpc间期按级差10ms分段,TpTe及TpTec间期按级差5ms分段,分别统计全部入选病例分布在各时段的病例数,计算各时段中频发VPB及VT+VF的发生率,再分别以这4项指标中各时段的上限值为变量,对室性心律失常的发生率与各时段上限值进行相关性研究。结果①VPB组及VT+VF组的JTp和JTpc间期虽均大于正常对照组(P<0.01),但与疾病对照组比较无显著差异。VPB组及VT+VF组的TpTe和TpTec间期不仅显著大于正常对照组(P<0.01),也显著大于疾病对照组(P<0.05)。②VPB及VT+VF的发生率与JTp和JTpc间期无明显相关性,而与TpTe和TpTec间期呈显著正相关(VPB:r=0.6649,r=0.6658,P<0.05;VT+VF:r=0.6977,r=0.6886,P<0.05)。结论JTp和JTpc间期对室性心律失常的发生无预测价值,而TpTe和TpTec间期可作为预测室性心律失常的心电图参考指标。

The prognostic value of JTp interval and TpTe interval to ventricular arrhythmia

Objective To study the prognostic value of J-T peak (JTp interval) and late T peak width (T peak-to-T end interval, TpTe interval) to ventricular arrhythmia through surface electrocardiogram. Methods 289 patients with different cardiac diseases were selected. From them those with frequent ventricular premature beat ( VPB≥30 beats/hour) or ventricular tachycardia (VT) or ventricular fibrillation (VF) were assigned into Group VPB (n=69) or Group VT+VF (n=62) respectively, other 60 patients without evident ventricular arrhythmia (VPB<5 beats/hour) were chosen to serve as disease controlled group ( Group D), and a normal controlled group was also set (Group N, n= 60). JTp, corrected JTp (JTpc) , and TpTe and corrected TpTe (TpTec) intervals were compared among the four groups. The ranges of JTp and JTpc intervals, TpTe and TpTec intervals in all patients were divided into several time intervals every 10 ms and every 5 ms respectively, the numbers of subjects and incidences of frequent VPB and VT+VF in each time interval were calculated,and the correlations between the morbidities of ventricular arrhythmia and the four indexes were studied. Results JTp and JTpc intervals in Group VPB and Group VT+VF were significantly longer than those in Group N (P<0.05), but were not significantly longer than those in Group D. TpTe and TpTec intervals in Group VPB and Group VT+VF were not only longer than those in Group N, but also longer than those in Group D (P<0.05). ②There were no significant correlations between incidences of ventricular arrhythmia and JTp and JTpc intervals, but positively significant correlations between incidences of ventricular arrhythmia and TpTe and TpTec intervals(VPB:r=0.6 649 and 0.6 658, P<0.05;VT+VF: r=0.6 977 and 0.6 886, P<0.05). Conclusions JTp and JTpc intervals have no prognostic values for incidence of ventricular arrhythmia while TpTe and TpTec intervals may serve as predictive electrocardiographic indexes of ventricular arrhythmia.