| 陈家亮1 夏宇希2 曹威3 陈凯3 王召军3△.微伏T波电交替对STEMI患者PCI术后室性心律失常的预测价值*[J].,2014,14(8):1500-1502 |
| 微伏T波电交替对STEMI患者PCI术后室性心律失常的预测价值* |
| The Predictive Value of Microvolf T-Wave Alternans for NonsustainedVentricular Tachycardia in Association with Percutaneous CoronaryIntervention in ST-segment Elevation Myocardial Infarction (STEMI) Patient* |
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| DOI： |
| 中文关键词: PCI ST段抬高心梗 室速 微伏T 波电交替 |
| 英文关键词: PCI ST-Segment Elevation Myocardial Infarction (STEMI) Ventricular tachycardia Microvolf T-wave alternans |
| 基金项目:黑龙江省教育厅基金项目（12531285） |
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| 中文摘要: |
| 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TIMI 3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± 6.4 vs 31.9± 3.8 μV, P< 0.05)。最大T 波电交替值大于45 μV 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。 |
| 英文摘要: |
| ABSTRACT Objective：To observe weather microvolf T-wave alternans (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, achieving
Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow. mTWA was measured using modified moving average method.
Results：MaximumMTWA 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. |
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