[1]古丽尼格尔·吾布力,夏木西娅·哈德尔,印纹源,等.冠心病患者动态心电图检查中P波离散度、T波峰-末间期的变化及诊断价值研究[J].陕西医学杂志,2024,(5):620-623.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.009]
 WUBULI·Gulinigeer,HADEER·Xiamuxiya,YIN Wenyuan,et al.Changes and diagnostic value of P-wave dispersion and T peak-T end interval in dynamic electrocardiogram in patients with coronary heart disease[J].,2024,(5):620-623.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.009]
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冠心病患者动态心电图检查中P波离散度、T波峰-末间期的变化及诊断价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年5期
页码:
620-623
栏目:
临床研究
出版日期:
2024-05-05

文章信息/Info

Title:
Changes and diagnostic value of P-wave dispersion and T peak-T end interval in dynamic electrocardiogram in patients with coronary heart disease
作者:
古丽尼格尔·吾布力1夏木西娅·哈德尔1印纹源1郭永忠2
(1.新疆维吾尔自治区人民医院心电学科,新疆 乌鲁木齐 830001; 2.新疆维吾尔自治区人民医院心外科,新疆 乌鲁木齐 830001)
Author(s):
WUBULI·GulinigeerHADEER·XiamuxiyaYIN WenyuanGUO Yongzhong
(Department of Electrocardiography,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
关键词:
冠心病 心律失常 心肌缺血 动态心电图 P波离散度 T波峰-末间期 诊断价值
Keywords:
Coronary heart disease Arrhythmia Myocardial ischemia Dynamic electrocardiogram P-wave dispersion T peak-T end interval Diagnostic value
分类号:
R 541.4
DOI:
DOI:10.3969/j.issn.1000-7377.2024.05.009
文献标志码:
A
摘要:
目的:探讨冠心病(CHD)患者动态心电图检查中P波离散度(Pd)、T波峰-末(Tp-Te)间期的变化及诊断价值。方法:选取CHD患者203例作为研究组,其中,心肌缺血95例作为心肌缺血组,心肌缺血合并心律失常108例作为心肌缺血合并心律失常组。另取同期体检健康者90例作为对照组。所有受试者均接受动态心电图检查,并记录Pd、Tp-Te间期情况。比较研究组和对照组以及心肌缺血组和心肌缺血合并心律失常组Pd、Tp-Te间期。绘制受试者工作特征曲线(ROC)分析Pd、Tp-Te间期对CHD及CHD心律失常的诊断价值。结果:研究组Pd、Tp-Te间期大于对照组(均P<0.05)。Pd、Tp-Te间期联合诊断CHD的AUC高于两者单独诊断的AUC(均P<0.05)。心肌缺血合并心律失常组Pd、Tp-Te间期大于心肌缺血组(均P<0.05)。Pd、Tp-Te间期联合诊断CHD患者心律失常的AUC高于两者单独诊断的AUC(均P<0.05)。结论:CHD患者动态心电图Pd增加及Tp-Te间期延长,且心肌缺血合并心律失常患者Pd增加及Tp-Te间期延长较心肌缺血患者更为明显,两者联合对CHD及CHD心律失常诊断价值较高。
Abstract:
Objective:To explore the changes and diagnostic value of P-wave dispersion(Pd)and T peak-T end(Tp-Te)interval in dynamic electrocardiogram in patients with coronary heart disease(CHD).Methods: A total of 203 patients with CHD were enrolled as study group,including 95 cases with myocardial ischemia in myocardial ischemia group and 108 cases with myocardial ischemia and arrhythmia in arrhythmia group.A total of 90 healthy controls during the same period were enrolled as control group.All the objects underwent dynamic electrocardiogram examination to record Pd and Tp-Te interval.Pd and Tp-Te interval were compared between study group and control group,and between myocardial ischemia group and arrhythmia group.The diagnostic value of Pd and Tp-Te interval for CHD and arrhythmia of CHD was analyzed by receiver operating characteristic(ROC)curves.Results: Pd and Tp-Te interval in study group were higher than those in control group(all P<0.05).AUC of Pd combined with Tp-Te interval in the diagnosis of CHD was greater than that of single index(all P<0.05).Pd and Tp-Te interval in arrhythmia group were higher than those in myocardial ischemia group(all P<0.05).AUC of Pd combined with Tp-Te interval in the diagnosis of arrhythmia was greater than that of single index(all P<0.05).Conclusion:The dynamic electrocardiogram of CHD patients shows an increase in Pd and an extension of Tp-Te interval,and the increase in Pd and an extension of Tp-Te interval are more significant in patients with myocardial ischemia combined with arrhythmia than in patients with myocardial ischemia.The two indexes have high diagnostic value for CHD and arrhythmia of CHD.

参考文献/References:

[1] KIANOUSH S,RIFAI M A,JAIN V,et al.Prevalence and predictors of premature coronary heart disease among Asians in the United States:A national health interview survey study[J].Curr Probl Cardiol,2023,48(7):101152.
[2] 肖翔,彭飞,周瑞.血清N端脑钠肽前体、肌红蛋白、D-二聚体水平与冠心病患者心室重构和主要心血管不良事件关系分析[J].陕西医学杂志,2023,52(6):697-700.
[3] 刘紫薇,成泽东,董宝强,等.基于“阴病治阳”理论探讨针刺治疗冠心病[J].陕西中医,2022,43(12):1768-1770.
[4] 王晓旭,石建明,蒋晓燕,等.老年人睡眠质量及睡眠时长与动态心电图校正的QT间期的关联分析[J].中国全科医学,2021,24(17):2157-2162.
[5] 王萍,龙滔,邵江.两种血清标志物联合24 h动态心电图对老年冠心病并发无症状心肌缺血的诊断价值[J].中华老年心脑血管病杂志,2020,22(9):934-937.
[6] 杜娟,徐金义,王庆义,等.P波离散度及P波最大时限诊断阵发性心房颤动的价值[J].中华实用诊断与治疗杂志,2022,36(3):292-294.
[7] 陈锐,李政宁,黄英华,等.院前急救心力衰竭患者血浆BNP与心电图QRS波时限及Tp-Te间期的相关性[J].中国老年学杂志,2019,39(15):3608-3610.
[8] 李绒,童惠平.晚发性子痫前期孕妇P波离散度与QT离散度变化及临床意义[J].陕西医学杂志,2021,50(12):1542-1545.
[9] 汪道文,曾和松.心血管内科疾病诊疗指南[M].北京:科学出版社,2013:62-67.
[10] AWTRY.心脏病学[M].北京:人民卫生出版社,2010:51-58.
[11] 赵添,邢亚明,于金平,等.生脉散联合阿托伐他汀对老年冠心病患者TLR4/MyD88/NF-κB信号通路的影响[J].陕西中医,2021,42(12):1703-1705,1720.
[12] 闻勇,王鹏,赵韧.术前中性粒细胞淋巴细胞比值和血小板淋巴细胞比值对老年冠心病患者非心脏术后心血管事件的预测价值[J].中国老年学杂志,2022,42(3):513-516.
[13] 俞雯吉,陈勇峻,杨晓宇,等.心外膜脂肪容积预测阻塞性冠心病伴心肌缺血的增益价值[J].中华心血管病杂志,2023,51(6):633-641.
[14] 周纪宁,向晋涛,来欣,等.48 h动态心电图检测价值的探讨[J].中国心脏起搏与心电生理杂志,2021,35(5):443-448.
[15] 王丽娟,李伦伦,杨琳琳.2D-STI联合动态心电图对急性心肌梗死患者预后结局的评估[J].影像科学与光化学,2022,40(6):1513-1518.
[16] 吴颖,刘卫其,张励庭,等.血清BNP、hs-CRP联合24 h动态心电图对老年冠状动脉性心脏病并发无症状心肌缺血的诊断价值[J].中国分子心脏病学杂志,2021,21(3):3945-3948.
[17] 李燕丽,孙静,陈燕,等.动态心电图结合临床路径评价冠心病伴心律失常的价值[J].影像科学与光化学,2022,40(2):316-319.
[18] 曹鹏,曹圣宇.心电图P波离散度与P波最大时限的平行和系列试验诊断对阵发性心房颤动的预测意义[J].中国慢性病预防与控制,2021,29(8):604-606.
[19] 赵香梅,秦历杰,李法良,等.Tp-e间期和Tp-e/QT比值对急性脑外伤患者预后的预测[J].中华急诊医学杂志,2020,29(2):253-256.
[20] 郑莉凡,张振玉,王秀芹.动态心电图P波离散度和Tp-e间期联合血压变异性对原发性高血压患者室性心律失常易感性的预测效能[J].中国心血管病研究,2023,21(6):538-543.
[21] 高洁,王新康,陈慧.P波离散度及QT间期离散度与妊娠期高血压疾病的相关性[J].中华高血压杂志,2021,29(4):349-353.
[22] 李阳春,张敏,雷蓉.扩张型心肌病预警恶性心律失常的心电指标Tp-Te间期与左室射血分数的相关性分析[J].中西医结合心脑血管病杂志,2022,20(14):2619-2623.
[23] 陈瑞绵,李军,徐聪,等.冠状动脉慢血流对心肌电活动的影响[J].中国老年学杂志,2020,40(20):4260-4263.
[24] BRAUN C C,ZINK M D,GOZDOWSKY S,et al.A longer Tpeak-Tend interval is associated with a higher risk of death:A meta-analysis[J].J Clin Med,2023,12(3):992.
[25] 吴敏,吴婧,张雅玲,等.心电图P波离散度和红细胞分布宽度与冠状动脉慢血流现象的关系研究[J].中国医学装备,2023,20(2):63-67.
[26] KOMATSUZAKI M,TAKASUSUKI T,KIMURA Y,et al.Assessment of the ECG T-wave in patients with subarachnoid hemorrhage[J].J Neurosurg Anesthesiol,2021,33(1):58-64.

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备注/Memo

备注/Memo:
基金项目:新疆维吾尔自治区自然科学基金资助面上项目(2022D01C132)
更新日期/Last Update: 2024-05-06