| 朱艳芳,范 倩,尹 岚,张 超,李 军.急性心肌梗死患者QT间期变异性与迷走神经功能损伤的相关性[J].,2021,(5):862-866 |
| 急性心肌梗死患者QT间期变异性与迷走神经功能损伤的相关性 |
| Correlation between QT Interval Variability and Vagal Nerve Injury in Patients with Acute Myocardial Infarction |
| 投稿时间：2020-09-06 修订日期：2020-09-30 |
| DOI：10.13241/j.cnki.pmb.2021.05.012 |
| 中文关键词: 急性心肌梗死 QT间期变异指数 迷走神经功能 相关性分析 |
| 英文关键词: Acute myocardial infarction QT interval variability index Vagal function Correlation analysis |
| 基金项目:湖北省卫生健康委员会联合基金项目（WJ2019H152） |
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| 中文摘要: |
| 摘要 目的：探讨急性心肌梗死（acute myocardial infarction, AMI）患者QT间期变异性与迷走神经功能（Vagal function,VNF）损伤的相关性。方法：选择2019年1月-2019年10月于我院确诊的AMI患者147例。所有患者入院后均进行常规心电图（Electrocardiogram, ECG）检查，而后通过计算分别得到代表患者QT间期变异性的QT间期变异指数（QT Interval Variation Index, QTVI）及反应心脏迷走神经功能的周期复极化动力学指数（Periodic Repolarization Kinetic Index, PRD）。通过PRD判断患者VNF等级后分为VNF0 ，VNF1 及VNF2 组。收集患者一般资料、实验室检查资料及ECG检查资料等，通过有序Logistic回归分析对QTVI与VNF的相关性进行分析。建立ROC曲线分析QTVI对AMI患者VNF损伤的预测效能。结果：VNF2 患者Killip分级Ⅲ级及ST段抬高占比、QTVI、HR、cTnI及NT-proBNP均显著高于VNF0及VNF1 患者，而LVEF显著低于VNF0 及VNF1 患者；VNF1 患者ST段抬高占比、QTVI、HR、cTnI及NT-proBNP均显著高于VNF0 患者，而LVEF显著低于VNF0 患者（P<0.05）。QTVI（OR=6.184，95%CI=4.345-11.298，P<0.05）及ST段抬高（OR=2.929, 95%CI=1.082-6.402，P<0.05）与VNF功能呈负相关，而LVEF（OR=0.847，95%CI=0.743-0.989，P<0.05）与VNF功能呈正相关。QTVI（AUC=0.881，95%CI=0.833-0.942， P<0.05）对于VNF发生具有较好的预测价值，QTVI预测VNF的最佳截点为0.814，敏感度为78.09%，特异度为86.04%。结论：QTVI对AMI患者VNF具有较好的预测价值，在今后的临床工作中可以将之运用于AMI患者的病情评价中。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between QT interval variability and vagal nerve function (VNF) injury in patients with acute myocardial infarction (AMI). Methods: A total of 147 patients with AMI diagnosed in our hospital from January 2019 to October 2019 were selected. All patients underwent routine electrocardiogram (ECG) examination after admission, and then calculated the QT interval variability index (QTVI) representing the patient's QT interval variability (QTVI) and the periodic repolarization kinetic index (PRD) reflecting cardiac vagal function. The PRD is used to determine the VNF level of the patients, and then the patients are grouped. The general data of the patients, laboratory examination data and ECG examination data are collected, and the correlation between QTVI and VNF is analyzed by ordered logistic regression analysis. Establish ROC curve to analyze the predictive power of QTVI on VNF injury in AMI patients. Results: In patients with VNF2, Killip grade III and ST-segment elevation ratio, QTVI, HR, cTnI, and NT-proBNP were significantly higher than those in patients with VNF0 and VNF1. The LVEF of VNF2 patients was significantly lower than that of VNF0 and VNF1 patients. The proportion of ST segment elevation, QTVI, HR, cTnI and NT-proBNP in VNF1 patients were significantly higher than those in VNF0 patients. VNF1 patients and LVEF were significantly lower than VNF0 patients (P<0.05). QTVI (OR = 6.184, 95% CI = 4.345-11.298, P<0.05) and ST segment elevation (OR = 2.929, 95%CI = 1.082-6.402, P<0.05) were negatively correlated with VNF function. LVEF (OR = 0.847, 95%CI = 0.743-0.989, P<0.05) was positively correlated with VNF function (P<0.05). QTVI (AUC = 0.881, 95%CI = 0.833-0.942, P<0.05) has a good predictive value for the occurrence of VNF (P<0.05), the best cut-off point predicted by QTVI is> 0.814, the prediction sensitivity is 78.09%, specificity is 86.04%. Conclusion: QTVI has good predictive value for VNF in AMI patients, and it can be used in the clinical evaluation of AMI patients in future clinical work. |
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