CAJ | 학술논문

目的探讨动态心电图分析系统时域法检测微伏级T波电交替(MTWA)对肥厚型心肌病患者恶性室性心律失常及心脏性猝死的预测价值。方法94例肥厚型心肌病患者（观察组）和105例健康人(对照组)接受24 h动态心电图检查并作MTWA检测，分析两年的死亡、晕厥及恶性心律失常的发生情况。结果对照组MTWA 95％正常值参考范围＜36μV。对照组MTWA＞36μV的占10.5％，观察组MTWA＞36μV的占55.3％。对照组无心血管事件发生；观察组发生恶性心律失常29例，MTWA＞36μV对恶性心律失常诊断的敏感性79.3％，特异性55.4％；阳性预测值44.2％，阴性预测值85.7％。结论 MTWA异常的肥厚型心肌病患者发生恶性室性心律失常及心脏性猝死的危险性增加。
목적탐토동태심전도분석계통시역법검측미복급T파전교체(MTWA)대비후형심기병환자악성실성심률실상급심장성졸사적예측개치。방법94례비후형심기병환자（관찰조）화105례건강인(대조조)접수24 h동태심전도검사병작MTWA검측，분석량년적사망、훈궐급악성심률실상적발생정황。결과대조조MTWA 95％정상치삼고범위＜36μV。대조조MTWA＞36μV적점10.5％，관찰조MTWA＞36μV적점55.3％。대조조무심혈관사건발생；관찰조발생악성심률실상29례，MTWA＞36μV대악성심률실상진단적민감성79.3％，특이성55.4％；양성예측치44.2％，음성예측치85.7％。결론 MTWA이상적비후형심기병환자발생악성실성심률실상급심장성졸사적위험성증가。
Objective To explore the value of microvolt T-wave alternations (MTWA) in predicting malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). Methods 24-hour dynamic ECG was recorded and MTWA was tested in 105 healthy subjects (control group) and 97 patients with HCM(HCM group).Death, syncope and malignant arrhythmia were analyzed during follow-up 2 years. Results The upper limit of 95%confidence interval of MTWA was<36μV in control group. The number of patients with MTWA >36μV was 10.5% in control group and 55.3% in HCMgroup. 29 cases had malignant VA in HCMgroup and no one had cardiovascular events in control group. The sensitivity, specificity, positive predictive value and negative predictive value of MTWA >36μV in diagnosis of malignant VA were 79.3%, 55.4%, 44.2% and 85.7%, respectively. Conclusion The risk of malignant VA and sudden cardiac death increases in HCMpatients with abnormal MTWA.