医学综述
醫學綜述
의학종술
Medical Recapitulate
2015年
20期
3820-3822
,共3页
心血管风险%心向量T环%有效评定
心血管風險%心嚮量T環%有效評定
심혈관풍험%심향량T배%유효평정
Cardiovascular risk%T ring VCG%Effective assessment
目的：研究不同分级不稳定型心绞痛患者心电向量T环的特征，探讨用 T环作为鉴别诊断的方法。方法选取2005年12月至2014年12月海口市人民医院收治的不稳定型心绞痛且有T环向量异常的患者146例作为研究对象，其中48 h内有反复静息心绞痛发作患者73例作为高危组，48 h内无而1个月内有静息心绞痛反复发作患者73例作为中危组，总结上述病例心绞痛发作前和发作时心电向量T环在额面、横面、右侧面三个面的状态（参考指标：QRS－T夹角、T环面积、T环形态）及转变。结果高危组或中危组的心电向量T环分别在额面、横面、右侧面三个面的参考指标组内相比较，各个组三个面之间的差异无统计学意义（ P ＞0.05）；高危组和中危组的心电向量 T环在额面或横面或右侧面某一面的图形变换组间比较，在任一面两组的差异有统计学意义（ P＜0.05）。①高危组额面、横面、右侧面 R－T 夹角最大变化量差≥5°的发生率显著高于中危组（86.3％比12.3％，90.4％比17.8％，83.6％比11.0％，P＜0.01）；②高危组额面、横面、右侧T环面积最大变化量差≥2 mm2的发生率显著高于中危组（89.0％比8.2％，93.2％比5.5％，86.3％比11.0％， P ＜0.01）；③高危组额面、横面、右侧T环扭结数差≥2个的发生率显著高于中危组（93.2％比13.7％，95.9％比8.2％，90.4％比17.8％，P＜0.01）。结论心电向量 T环是有效评估心血管风险的可考量的指标。
目的：研究不同分級不穩定型心絞痛患者心電嚮量T環的特徵，探討用 T環作為鑒彆診斷的方法。方法選取2005年12月至2014年12月海口市人民醫院收治的不穩定型心絞痛且有T環嚮量異常的患者146例作為研究對象，其中48 h內有反複靜息心絞痛髮作患者73例作為高危組，48 h內無而1箇月內有靜息心絞痛反複髮作患者73例作為中危組，總結上述病例心絞痛髮作前和髮作時心電嚮量T環在額麵、橫麵、右側麵三箇麵的狀態（參攷指標：QRS－T夾角、T環麵積、T環形態）及轉變。結果高危組或中危組的心電嚮量T環分彆在額麵、橫麵、右側麵三箇麵的參攷指標組內相比較，各箇組三箇麵之間的差異無統計學意義（ P ＞0.05）；高危組和中危組的心電嚮量 T環在額麵或橫麵或右側麵某一麵的圖形變換組間比較，在任一麵兩組的差異有統計學意義（ P＜0.05）。①高危組額麵、橫麵、右側麵 R－T 夾角最大變化量差≥5°的髮生率顯著高于中危組（86.3％比12.3％，90.4％比17.8％，83.6％比11.0％，P＜0.01）；②高危組額麵、橫麵、右側T環麵積最大變化量差≥2 mm2的髮生率顯著高于中危組（89.0％比8.2％，93.2％比5.5％，86.3％比11.0％， P ＜0.01）；③高危組額麵、橫麵、右側T環扭結數差≥2箇的髮生率顯著高于中危組（93.2％比13.7％，95.9％比8.2％，90.4％比17.8％，P＜0.01）。結論心電嚮量 T環是有效評估心血管風險的可攷量的指標。
목적：연구불동분급불은정형심교통환자심전향량T배적특정，탐토용 T배작위감별진단적방법。방법선취2005년12월지2014년12월해구시인민의원수치적불은정형심교통차유T배향량이상적환자146례작위연구대상，기중48 h내유반복정식심교통발작환자73례작위고위조，48 h내무이1개월내유정식심교통반복발작환자73례작위중위조，총결상술병례심교통발작전화발작시심전향량T배재액면、횡면、우측면삼개면적상태（삼고지표：QRS－T협각、T배면적、T배형태）급전변。결과고위조혹중위조적심전향량T배분별재액면、횡면、우측면삼개면적삼고지표조내상비교，각개조삼개면지간적차이무통계학의의（ P ＞0.05）；고위조화중위조적심전향량 T배재액면혹횡면혹우측면모일면적도형변환조간비교，재임일면량조적차이유통계학의의（ P＜0.05）。①고위조액면、횡면、우측면 R－T 협각최대변화량차≥5°적발생솔현저고우중위조（86.3％비12.3％，90.4％비17.8％，83.6％비11.0％，P＜0.01）；②고위조액면、횡면、우측T배면적최대변화량차≥2 mm2적발생솔현저고우중위조（89.0％비8.2％，93.2％비5.5％，86.3％비11.0％， P ＜0.01）；③고위조액면、횡면、우측T배뉴결수차≥2개적발생솔현저고우중위조（93.2％비13.7％，95.9％비8.2％，90.4％비17.8％，P＜0.01）。결론심전향량 T배시유효평고심혈관풍험적가고량적지표。
Objective To research the characteristics of vectorcardiogram T ring VCG of unstable angina patients of different grades,to discuss the differential clinical diagnosis with T ring.Methods The study selected 146 cases of unstable angina pectoris and abnormal T vector in Haikou City People′s Hospital from Dec.2005 to Dec.2014,including 73 cases in high risk group with recurrent quiet angina within 48 hours, and 73 cases in intermediate risk group with recurrent quiet angina in 1 month but not within 48 hours.The changed state of T ring VCG( reference indicators:QRS-T angle,T ring area,T ring shape) on the three faces (frontalis,horizontal,right side) in these case were summarized.Results The changed state of T ring VCG respectively among the three faces (frontalis,horizontal surface,right side) had no statistically significant difference(P>0.05) in the intermediate risk group or high risk group;the changed state of T ring VCG on any of the three faces between the two groups had statistically significant difference(P <0.05).①The incidence of R-T angle maximum differential variation ≥5°in the high risk group was significantly higher than in the intermediate risk group(86.3% vs 12.3%,90.4% vs 17.8%,83.6% vs 11.0%,P<0.01);②The incidence of T area maximum differential variation ≥2 mm2 ,in the high risk group was significantly higher than in the intermediate risk group(89.0% vs 8.2%,93.2% vs 5.5%,86.3% vs 11.0%,P <0.01 ); ③The incidence of T ring kink differential number≥2 in the high risk group was significantly higher than in the intermediate risk group(93.2% vs 13.7%,95.9% vs 8.2%,90.4% vs 17.8%,P<0.01). Conclusion T ring VCG is an effective measurable assessment indicator of cardiovascular risk .
