心电图Tp-Te、Tp-Te/QT在诊断AMI伴室性心律失常中的价值

张桂艳; 刘涛; 孙亚明

文章摘要

张桂艳，刘涛，孙亚明.心电图Tp-Te、Tp-Te/QT在诊断AMI伴室性心律失常中的价值[J].实用中西医结合临床,2023,23(7):1-5

心电图Tp-Te、Tp-Te/QT在诊断AMI伴室性心律失常中的价值

Value of Electrocardiogram Tp-Te and Tp-Te/QT in the Diagnosis of AMI with Ventricular Arrhythmia

DOI：

中文关键词: 急性心肌梗死室性心律失常心电图心功能

英文关键词: Acute myocardial infarction Ventricular arrhythmia ECG Cardiac function

基金项目:

作者	单位
张桂艳，刘涛，孙亚明	河南省新乡医学院第二附属医院；河南省精神病医院

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中文摘要:

目的：分析心电图T波顶点到T波终点时限（Tp-Te）、Tp-Te与QT间期的比值（Tp-Te/QT）在诊断急性心肌梗死（AMI）伴室性心律失常（VA）中的价值。方法：选取2019年1月至2022年12月医院收治的50例AMI伴VA患者为AMI伴VA组，另选取同期50例单纯AMI患者为单纯AMI组。记录并比较两组心功能[每搏输出量（SV）、左室射血分数（LVEF）、氨基末端脑钠肽前体（NT-proBNP）、肌钙蛋白Ⅰ（cTnⅠ）]、急性恢复期及恢复期心电图指标[Tp-Te、Tp-Te/QT、校正后Tp-Te间期（Tp-Tec）、校正的QT间期（QTc）]；采用双相关变量Pearson分析心功能与心电图指标的关系；采用接受者操作特征（ROC）曲线分析心电图Tp-Te，Tp-Te/QT在诊断AMI伴VA中的价值。结果：AMI伴VA组SV、LVEF比单纯AMI组低，NT-proBNP、cTnⅠ比单纯AMI组高（P＜0.05）；AMI伴VA组急性期Tp-Te、Tp-Te/QT、Tp-Tec、QTc比单纯AMI组高（P＜0.05）；两组恢复期Tp-Te、Tp-Te/QT、Tp-Tec、QTc比较，差异无统计学意义（P＞0.05）；采用双相关变量Pearson分析结果显示，SV、LVEF与Tp-Te、Tp-Te/QT、Tp-Tec呈负相关（r＜0，P＜0.05），NT-proBNP与Tp-Te、Tp-Tec、QTc，cTnⅠ与Tp-Te、Tp-Tec呈正相关（r＞0，P＜0.05）；绘制ROC曲线结果显示，Tp-Te、Tp-Te/QT、Tp-Tec、QTc及联合检测诊断AMI伴VA的曲线下面积（AUC）分别为0.736、0.775、0.784、0.671、0.885。结论：心电图Tp-Te、Tp-Te/QT与AMI患者心功能呈负相关，各指标联合可有效诊断AMI伴VA的发生。

英文摘要:

Objective: To analyze the value of time limit from the apex of T wave to the endpoint of T wave (Tp-Te) and the ratio of Tp-Te to QT interval (Tp-Te/QT) in the diagnosis of acute myocardial infarction (AMI) with ventricular arrhythmia (VA). Methods: A total of 50 patients with AMI complicated with VA admitted to hospital from January 2019 to December 2022 were selected as AMI complicated with VA group, and another 50 patients with simple AMI in the same period were selected as simple AMI group. Cardiac function [stroke volume (SV), left ventricular ejection fraction (LVEF), Amino-terminal brain natriuretic peptide precursor (NT-proBNP), and troponin Ⅰ(cTnⅠ)], and electrocardiogram indexes of acute recovery period and recovery period [Tp-Te, Tp-Te/QT, corrected Tp-Te interval (Tp-Tec), and corrected QT interval (QTc)] were recorded and compared between the two groups. Pearson, a double correlated variable, was used to analyze the relationship between cardiac function and ECG indicators. The receiver operating characteristic (ROC) curve was used to analyze the value of ECG Tp-Te and Tp-Te/QT in the diagnosis of AMI with VA. Results: SV and LVEF of AMI complicated with VA group were lower than those of simple AMI group, while NT-proBNP and cTnⅠ were higher than those of simple AMI group (P＜0.05). The levels of Tp-Te, Tp-Te/QT, Tp-Tec and QTc in AMI complicated with VA group acute phase were higher than those in simple AMI group alone (P＜0.05). There was no significant difference in the levels of Tp-Te, Tp-Te/QT, Tp-Tec and QTc during the recovery period between the two groups (P＞0.05). Pearson analysis with dual correlation variables showed that SV and LVEF had negative correlations with Tp-Te, Tp-Te/QT and Tp-Tec (r＜0, P＜0.05), while NT-proBNP had positive correlations with Tp-Te, Tp-Tec, QTc and cTnⅠ with Tp-Te and Tp-Tec (r＞0, P＜0.05). The results of the ROC curve showed that the Area under curve (AUC) of Tp-Te, Tp-Te/QT, Tp-Tec, QTc, and the combination tests for AMI with VA were 0.736, 0.775, 0.784, 0.671, and 0.885, respectively. Conclusion: ECG Tp-Te and Tp-Te/QT have negative correlation with cardiac function in patients with AMI. The combination of these indicators can effectively diagnose the occurrence of AMI accompanied with VA.

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