Tp-e間期與慢性心力衰竭患者合并室性心律失常的關(guān)系研究
發(fā)布時間：2018-09-14 20:13
【摘要】：目的:評價Tp-e間期與慢性心力衰竭(CHF)患者合并室性心律失常的關(guān)系以及其對CHF患者合并室性心律失常的診斷價值。方法:收集我院心內(nèi)科住院的慢性心力衰竭(CHF)患者(心功能NYHAII-IV級)129人(CHF組),將其按有無合并室性心律失常及室性心律失常的類型分為室性期前收縮組36人(室早組,單發(fā)室性早搏3000次/24小時或出現(xiàn)二聯(lián)律、三聯(lián)律、多源性室性早搏及成對出現(xiàn)的早搏),室性心動過速組40人(室速組),無室性心律失常組53人,納入同時期在我院住院且行24小時動態(tài)心電圖(Holter)檢查并排除心血管疾病、離子紊亂等影響Tp-e間期的相關(guān)疾病后的住院患者67人(對照組),上述入選者均于入院當(dāng)天行心電圖(ECG)檢查,住院期間行Holter檢查,測量所有入選患者V2導(dǎo)聯(lián)Tp-e間期值,同時收集其超聲心動圖及相關(guān)實驗室檢查結(jié)果,評價Tp-e間期與CHF患者合并室性心律失常的關(guān)系。結(jié)果:1.CHF組與對照組相比,總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、心率、射血分?jǐn)?shù)(EF)、左室舒張末內(nèi)徑(LVEDd)存在統(tǒng)計學(xué)差異(P0.05),其余觀察指標(biāo)無統(tǒng)計學(xué)差異。CHF室早組、CHF室速組、CHF無室性心律失常組三組間比較吸煙史、NYHA心功能分級、血紅蛋白(Hb)、EF值及LVEDd存在統(tǒng)計學(xué)差異(P0.05)。2.CHF組與對照組QT間期、QTc、QRS間期、Tp-e間期及Tp-e/QT比值比較差異均有統(tǒng)計學(xué)意義(P0.05);Tp-e間期及Tp-e/QT比值在室速組、室早組、無室性心律失常組組間比較中差異均有統(tǒng)計學(xué)差異(P0.05),且隨著室性心律失常嚴(yán)重程度的增高,Tp-e間期及Tp-e/QT比值隨之延長。3.當(dāng)Tp-e間期為105ms,Tp-e/QT比值為0.251時其預(yù)測CHF患者合并室性心律失常的靈敏度、特異度及ROC曲線下面積最大。結(jié)論:可將Tp-e間期及Tp-e/QT比值作為預(yù)測CHF患者合并室性心律失常的非侵入性檢查指標(biāo)。
[Abstract]:Objective: to evaluate the relationship between Tp-e interval and ventricular arrhythmia in (CHF) patients with chronic heart failure and its diagnostic value in CHF patients with ventricular arrhythmia. Methods: a total of 129 (CHF) patients with chronic heart failure (cardiac function NYHAII-IV grade) in our hospital were divided into three groups according to the types of ventricular arrhythmias and ventricular arrhythmias. Single ventricular premature beats occurred in 3000 / 24 hours, or in the second, triple, multisource and paired premature beats), and in the ventricular tachycardia group, 40 patients (ventricular tachycardia group), 53 patients without ventricular arrhythmia, They were admitted to our hospital at the same time and underwent 24 hour ambulatory electrocardiogram (Holter) examination and exclusion of cardiovascular disease. There were 67 inpatients (control group) who suffered from related diseases such as ion disturbance. The patients were examined with (ECG) on the day of admission and Holter during hospitalization. The Tp-e interval of V2 lead was measured in all the patients. The results of echocardiography and laboratory examination were collected to evaluate the relationship between Tp-e interval and ventricular arrhythmia in CHF patients. Results 1. Compared with control group, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), heart rate, Ejection fraction (EF),) left ventricular end-diastolic diameter (LVEDd) was statistically different (P0.05). There were significant differences in EF value of hemoglobin (Hb) and LVEDd between CHF group and control group (P0.05). There were significant differences in QT interval Tp-e interval and Tp-e/QT ratio between CHF group and control group. (P0.05) Tp-e interval and Tp-e/QT ratio in ventricular tachycardia group and early ventricular group were significantly different between CHF group and control group. There were significant differences between the groups without ventricular arrhythmia (P0.05), and with the increase of the severity of ventricular arrhythmias, the Tp-e interval and the ratio of Tp-e/QT were prolonged. 3. The sensitivity, specificity and area under the ROC curve of CHF patients with ventricular arrhythmias were highest when the Tp-e interval was 105 Ms ~ (-1) Tp-e / QT ratio of 0.251. Conclusion: Tp-e interval and Tp-e/QT ratio can be used as noninvasive indexes for predicting ventricular arrhythmia in CHF patients.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541
本文編號：2243755
[Abstract]:Objective: to evaluate the relationship between Tp-e interval and ventricular arrhythmia in (CHF) patients with chronic heart failure and its diagnostic value in CHF patients with ventricular arrhythmia. Methods: a total of 129 (CHF) patients with chronic heart failure (cardiac function NYHAII-IV grade) in our hospital were divided into three groups according to the types of ventricular arrhythmias and ventricular arrhythmias. Single ventricular premature beats occurred in 3000 / 24 hours, or in the second, triple, multisource and paired premature beats), and in the ventricular tachycardia group, 40 patients (ventricular tachycardia group), 53 patients without ventricular arrhythmia, They were admitted to our hospital at the same time and underwent 24 hour ambulatory electrocardiogram (Holter) examination and exclusion of cardiovascular disease. There were 67 inpatients (control group) who suffered from related diseases such as ion disturbance. The patients were examined with (ECG) on the day of admission and Holter during hospitalization. The Tp-e interval of V2 lead was measured in all the patients. The results of echocardiography and laboratory examination were collected to evaluate the relationship between Tp-e interval and ventricular arrhythmia in CHF patients. Results 1. Compared with control group, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), heart rate, Ejection fraction (EF),) left ventricular end-diastolic diameter (LVEDd) was statistically different (P0.05). There were significant differences in EF value of hemoglobin (Hb) and LVEDd between CHF group and control group (P0.05). There were significant differences in QT interval Tp-e interval and Tp-e/QT ratio between CHF group and control group. (P0.05) Tp-e interval and Tp-e/QT ratio in ventricular tachycardia group and early ventricular group were significantly different between CHF group and control group. There were significant differences between the groups without ventricular arrhythmia (P0.05), and with the increase of the severity of ventricular arrhythmias, the Tp-e interval and the ratio of Tp-e/QT were prolonged. 3. The sensitivity, specificity and area under the ROC curve of CHF patients with ventricular arrhythmias were highest when the Tp-e interval was 105 Ms ~ (-1) Tp-e / QT ratio of 0.251. Conclusion: Tp-e interval and Tp-e/QT ratio can be used as noninvasive indexes for predicting ventricular arrhythmia in CHF patients.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541
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