中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2009年
2期
117-120
,共4页
薛社亮%侯小锋%徐东杰%单其俊%陈明龙%陈椿%杨兵%张荣%殷海萍%邹建刚%曹克将
薛社亮%侯小鋒%徐東傑%單其俊%陳明龍%陳椿%楊兵%張榮%慇海萍%鄒建剛%曹剋將
설사량%후소봉%서동걸%단기준%진명룡%진춘%양병%장영%은해평%추건강%조극장
活动平板%微伏级T波电交替%敏心律失常性右心室心肌病%右心室室性心动过速
活動平闆%微伏級T波電交替%敏心律失常性右心室心肌病%右心室室性心動過速
활동평판%미복급T파전교체%민심률실상성우심실심기병%우심실실성심동과속
Modified moving average analyses%Microvolt T-wave alternans%Arrhythmogenic right ven-tricular cardiomyopathy%Idiopathic right ventricular tachycardia
目的 探讨右心室室性心动过速患者时域法微伏级T波电交替(MTWA)特征及其临床意义.方法 采用活动平板时域法分别对35例致心律失常性右心室心肌病(ARVC)患者(其中男性28例,平均年龄(38.6±11.0)岁]、10例特发性右心室室性心动过速(IRVT)患者[其中男性7例,平均年龄(41.9±15.4)岁]和60例健康对照者[男性42例,平均年龄(41.0±14.9)岁]进行MTWA检测,记录胸前V1～V6导联的MTWA值,确定胸前各导联的最大值,以MaxValt表示.分析比较不同组别各导联MTWA值及MaxValt值的差异.结果 ARVC组各导联MTWA值和MaxValt值均明显高于对照组(P<0.01);IRVT组各导联的MTWA值和MaxValt值比对照组升高,但差异无统计学意义(P>0.05);ARVC组和IRVT组比较,V4导联MTWA值及MaxValt值明显较高(P<0.05);接受者操作特性(receiver oper-ating characteristic,ROC)曲线分析表明,以MaxValt>11.5μV鉴别诊断ARVC的敏感性为74.3%,特异性为80.0%;ARVC组中,近一年内有持续性室速发生的患者较无室速发作患者V2～V6导联的MTWA值以及MaxValt值的差异有统计学意义.结论 渐量修正平均时域法检测显示,ARVC患者MTWA值和MaxValt值均明显升高,MTWA值可以反映ARVC患者近期室性心动过速的发作.
目的 探討右心室室性心動過速患者時域法微伏級T波電交替(MTWA)特徵及其臨床意義.方法 採用活動平闆時域法分彆對35例緻心律失常性右心室心肌病(ARVC)患者(其中男性28例,平均年齡(38.6±11.0)歲]、10例特髮性右心室室性心動過速(IRVT)患者[其中男性7例,平均年齡(41.9±15.4)歲]和60例健康對照者[男性42例,平均年齡(41.0±14.9)歲]進行MTWA檢測,記錄胸前V1～V6導聯的MTWA值,確定胸前各導聯的最大值,以MaxValt錶示.分析比較不同組彆各導聯MTWA值及MaxValt值的差異.結果 ARVC組各導聯MTWA值和MaxValt值均明顯高于對照組(P<0.01);IRVT組各導聯的MTWA值和MaxValt值比對照組升高,但差異無統計學意義(P>0.05);ARVC組和IRVT組比較,V4導聯MTWA值及MaxValt值明顯較高(P<0.05);接受者操作特性(receiver oper-ating characteristic,ROC)麯線分析錶明,以MaxValt>11.5μV鑒彆診斷ARVC的敏感性為74.3%,特異性為80.0%;ARVC組中,近一年內有持續性室速髮生的患者較無室速髮作患者V2～V6導聯的MTWA值以及MaxValt值的差異有統計學意義.結論 漸量脩正平均時域法檢測顯示,ARVC患者MTWA值和MaxValt值均明顯升高,MTWA值可以反映ARVC患者近期室性心動過速的髮作.
목적 탐토우심실실성심동과속환자시역법미복급T파전교체(MTWA)특정급기림상의의.방법 채용활동평판시역법분별대35례치심률실상성우심실심기병(ARVC)환자(기중남성28례,평균년령(38.6±11.0)세]、10례특발성우심실실성심동과속(IRVT)환자[기중남성7례,평균년령(41.9±15.4)세]화60례건강대조자[남성42례,평균년령(41.0±14.9)세]진행MTWA검측,기록흉전V1～V6도련적MTWA치,학정흉전각도련적최대치,이MaxValt표시.분석비교불동조별각도련MTWA치급MaxValt치적차이.결과 ARVC조각도련MTWA치화MaxValt치균명현고우대조조(P<0.01);IRVT조각도련적MTWA치화MaxValt치비대조조승고,단차이무통계학의의(P>0.05);ARVC조화IRVT조비교,V4도련MTWA치급MaxValt치명현교고(P<0.05);접수자조작특성(receiver oper-ating characteristic,ROC)곡선분석표명,이MaxValt>11.5μV감별진단ARVC적민감성위74.3%,특이성위80.0%;ARVC조중,근일년내유지속성실속발생적환자교무실속발작환자V2～V6도련적MTWA치이급MaxValt치적차이유통계학의의.결론 점량수정평균시역법검측현시,ARVC환자MTWA치화MaxValt치균명현승고,MTWA치가이반영ARVC환자근기실성심동과속적발작.
Objective To explore the features and clinical significance of microvoh T-wave alternans (MTWA) using modified moving average analyses in patients with right ventricular tachycardia. Methods MTWA voltages were detected using modified moving average analyses with exercise in 35 patients with arrhyth-mogenic right ventricular cardiomyopathy(ARVC)tachycardia, in 10 patients with idiopathic right ventricular tachycardia(IRVT),and in 60 healthy persons as control. MTWA voltages in precordial lead V1～V6 were re-corded. The maximal MTWA voltages were expressed as MaxValt. The MTWA voltages were compared among ARVC group,the IRVTgroup,and control group. Results The voltages of MTWA in all precordial leads were higher in ARVC group than those in control group (P<0.01). There was no significant difference between IRVT and control group(P>0.05). The voltages of MTWA in lead V4 and the MaxVah were higher in ARVC group than those in IRVT group (P<0.05). The receiver-operating characteristics (ROC) curves for MTWA showed that the sensitivity and specificity for predicting ARVC was 74.3% and 80.0% ,respectively,when the 11.5 μV was chosen as cutpaint value of MaxValt. In ARVC group,the voltages of MTWA in lead V2、V3、V4、V6 and MaxValt were greater in those with occurrence of sustained ventricular tachycardia in previous one year than in those without ventricular tachycardia occurrence (P<0.05). Conclusions The voltages of MTWA de-tected with modified moving average method are significantly higher in ARVC patients. MTWA might be related to the late occurrence of ventricular tachycardia in ARVC patients.
