摘要
目的：探讨微伏T波电交替增高与STEMI患者PCI术后室性心律失常的发生关系。方法：选择我院2011年4月-2013年4月收治的68例STEMI患者，所有患者均成功进行了直接PCI，且阻塞远端血流均达到TIMI3级。所有患者于手术后进行了24小时动态心电图检查，并测定微伏T波电交替值。结果：36例发生NSVT患者较未发生32例患者最大微伏T波电交替明显升高，（68．1±6．4VS31．9±3．8μV，P〈0．05）。最大T波电交替值大于45μV预测非持续性室速发生的敏感性为75％，特异性为72％；阳性预测值为70％。阴性预测值77％（AUC=0．84）。经过进一步比较分析发现，ST段抬高的程度与非持续室速的发生无关（AUC=0．61）。结论：微伏T波电交替可预测STEMI患者PCI术后室性心律失常的发生。
Objeetive： To observe weather microvolf T-wave altemans （mTWA） level is correlated with nonsustained ventric-ular tachycardia （NSVT） incidence in association with PCI in patients with acute ST-segment elevationmyocardial infarction （STEMI）. Methods： We analyzed continuous 24-hour ambulatory electrocardiograms in 68 STEMI patients during and after successful primary PCI, achiev- ing Thrombolysis in Myocardial Infarction （TIMI） grade 3 flow. mTWA was measured using modified moving average method. Results： Maximum MTWA was elevated in patients with （N=36） compared to without （N=32） NSVT （68.1± 6.4 vs 31.9± 3.8 μV, P〈0.05）during the 24-hour monitoring period. MTWA ≥ 45 μV predicted NSVT with sensitivity of 75%; specificity,72%; positive predictive value, 70%; and negative predictive value, 77%. Area under receiver operator characteristic curve （AUC） was 0.84 for maximum MTWA in predicting NSVT. By comparison, ST-segment levels did not differ in patients with versus without NSVT and were not predictive （AUC = 0.61）. Conclusion： MTWA may be useful in identifying individuals at heightened risk for arrhythmia in association with pri- mary PCI and can potentially signal time-dependent changes in arrhythmia vulnerability.
出处
《现代生物医学进展》
CAS
2014年第8期1500-1502,1506,共4页
Progress in Modern Biomedicine
基金
黑龙江省教育厅基金项目(12531285)
关键词
PCI
ST段抬高心梗
室速
微伏T波电交替
PCI
ST-Segment Elevation Myocardial Infarction （STEMI）
Ventricular tachycardia
Microvolf T-wave altemans
