摘要
目的探究急性心肌梗死患者的心电图参数变化与发生室性心律失常的关系。方法选取2020年6月—2022年6月南安市医院收治的急性心肌梗死患者120例,根据入院24 h内是否发生室性心律失常分为观察组(发生室性心律失常)50例和对照组(未发生室性心律失常)70例。所有患者入院后均给予十二导联动态心电分析系统监测24 h心电活动,采用心电散点图技术测量24 h QT间期变异性(24 hQTV)、24 h正常心房开始除极至心室开始除极时间(R-R)间期标准差(SDNN)、24 h连续5 min正常R-R间期标准差(SDANN-index)、24 h连续5 min正常R-R间期标准差均值(SDNN-index),检测两组患者急性期以及恢复期的T波-末间期(Tp-Te)、经心率校正的波峰-末间期(Tp-Tec)、波峰-末间期离散度(Tp-Ted),比较两组的上述心电图参数,采用Spearman相关法分析心电图参数变化与发生室性心律失常的相关性。结果观察组的24 h QTV、SDNN、SDANN-index、SDNN-index较对照组均明显延长,差异有统计学意义(P<0.05)。两组患者的Tp-Te、Tp-Tec、Tp-Ted在心肌梗死恢复期较急性期明显改善,差异有统计学意义(P<0.05);观察组的Tp-Te、Tp-Tec、Tp-Ted在急性期和恢复期较对照组均明显延长,差异有统计学意义(P<0.05)。Spearman’s分析研究结果显示,急性心肌梗死患者的24 h QTV、SDNN、SDANNindex、SDNN-index、Tp-Te、Tp-Tec、Tp-Ted心电图参数与发生室性心律失常呈正相关(P均<0.05)。结论急性心肌梗死患者的24 h QTV、SDNN、SDAN-index、SDNN-index、Tp-Te、Tp-Tec、Tp-Ted等心电图参数与发生室性心律失常呈正相关,临床可以结合心电图参数变化评估患者病情,可尝试作为预示发生室性心律失常的相关指标。
Objective To explore the relationship between the changes of ECG parameters and the occurrence of ventricular arrhythmia in patients with acute myocardial infarction.Methods A total of 120 patients with acute myocardial infarction admitted to our hospital from June 2020 to June 2022 were selected.According to whether ventricular arrhythmia occurred within 24 hours after admission,they were divided into test group(50 patients with ventricular arrhythmia)and matched group(70 patients without ventricular arrhythmia).After admission,all patients were given 12-lead dynamic ECG analysis system to monitor the 24-hour ECG activity,and the 24-hour QT interval variability(24 h QTV),the standard deviation(SDNN)of the time from the beginning of normal atrial depolarization to the beginning of ventricular depolarization(R-R),the standard deviation of the normal R-R interval(SDANNindex),and the mean standard deviation(SDNN-index)of the normal R-R interval for 5 consecutive minutes in 24 hours were measured using the ECG scatter plot technique,T wave-end interval(Tp-Te),heart rate corrected peak-end interval(Tp-Tec)and peak-end interval dispersion(Tp-Ted)were measured in the acute and convalescent phases of the two groups.The above ECG parameters were compared between the two groups.The correlation between the changes of ECG parameters and the occurrence of ventricular arrhythmia was analyzed by Spearman's correlation method.Results The 24 h QTV,SDNN,SDANN-index and SDNN-index in the test group were significantly longer than those in the matched group(P<0.05).Tp-Te,Tp-Tec and Tp-Ted of patients in the two groups were significantly improved in the recovery phase of myocardial infarction compared with those in the acute phase(P<0.05).The Tp-Te,Tp-Tec and Tp-Ted in the test group were significantly longer than those in the matched group in the acute and convalescent phases(P<0.05).The results of Spearman's analysis showed that the ECG parameters,such as 24 h QTV,SDNN,SDANN-index,SDNN-index,Tp-Te,Tp-Tec,Tp-Ted in patients with acute myocardial infarction were positively correlated with the occurrence of ventricular arrhythmia(r=0.022,0.131,0.045,0.039,0.620,0.685,0.747;P<0.05).Conclusion The ECG parameters of 24 h QTV,SDNN,SDANN-index,SDNN-index,Tp-Te,Tp-Tec,Tp-Ted and so on in patients with acute myocardial infarction are positively correlated with the occurrence of ventricular arrhythmia.The clinical condition of patients can be evaluated by combining the changes of ECG parameters,which can be used as a relevant indicator to predict the occurrence of ventricular arrhythmia.
作者
黄建慧
HUANG Jianhui(Cardiovascular Department ECG Center of Nan'an Hospital,Nan'an 362300,Fujian Province,China)
出处
《中国实用乡村医生杂志》
2023年第2期54-57,61,共5页
Chinese Practical Journal of Rural Doctor
