影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (3): 625-630.DOI: 10.7517/issn.1674-0475.211208

• 综述与论文 • 上一篇    下一篇

冠心病冠状动脉狭窄程度对心室复极化指标的影响研究

利冬梅1, 刘良华2, 莫艳丽2, 黄军章3   

  1. 1. 钦州市第二人民医院心电诊断科, 广西 钦州 535000;
    2. 钦州市第二人民医院超声诊断科, 广西 钦州 535000;
    3. 钦州市第二人民医院心血管内科, 广西 钦州 535000
  • 收稿日期:2021-12-20 出版日期:2022-05-15 发布日期:2022-05-27
  • 通讯作者: 广西自然科学基金(20211799)

Effects of Coronary Artery Stenosis Degree on Ventricular Repolarization Indexes in Patients with Coronary Heart Disease

LI Dongmei1, LIU Lianghua2, MO Yanli2, HUANG Junzhang3   

  1. 1. Department of ECG Diagnosis, The Second People's Hospital of Qinzhou, Qinzhou 535000, Guangxi, P. R. China;
    2. Department of Utrasound Diagnosis, The Second People's Hospital of Qinzhou, Qinzhou 535000, Guangxi, P. R. China;
    3. Department of Cardiology, The Second People's Hospital of Qinzhou, Qinzhou 535000, Guangxi, P. R. China
  • Received:2021-12-20 Online:2022-05-15 Published:2022-05-27

摘要: 本次研究目的为探讨冠心病冠状动脉狭窄程度对心室复极化指标的影响。选取冠心病患者105例作为观察组,其中急性冠状动脉综合征(ACS)63例,稳定型心绞痛(SAP)42例。同时选取非冠心病患者60例作为对照组,比较两组心电图、心脏超声参数差异。观察组QT变异度(QTV)、心率校正后QT (QTc)间期、T波峰末期间(TpTe)、T波峰末期间/QRS波开始到T波结束的时间(TpTe/QT)、左房内径、左室后壁厚度、室间隔厚度、左室舒张末期内径明显高于对照组(P<0.05),而左室射血分数(LVEF)明显低于对照组(P<0.05)。观察组ACS患者TpTe、TpTe/QT和左房内径明显高于SAP患者(P<0.05),而左室射血分数明显低于SAP患者(P<0.05)。观察组重度狭窄患者QTv、QTc间期、TpTe、TpTe/QT、左室舒张末期内径明显高于轻中度狭窄患者(P<0.05),而左室射血分数明显低于轻中度狭窄患者(P<0.05)。Gensini评分与QTv、QTc间期、TpTe、TpTe/QT呈正相关(P<0.05),而与左室射血分数呈负相关(P<0.05)。QTv、QTc间期、TpTe、TpTe/QT联合左室射血分数预测重度狭窄的ROC曲线下面积为0.931,P<0.05。冠心病冠状动脉狭窄程度与心室复极化指标呈正相关,心室复极化指标在预测冠状动脉狭窄程度方面有一定价值。

关键词: 冠心病, 冠状动脉狭窄程度, 心室复极化指标, 相关性

Abstract: The purpose of this study was to investigate the effect of coronary artery stenosis degree on ventricular repolarization indexes. Chosen 105 patients with coronary heart disease as observation group, including 63 cases of acute coronary syndrome (ACS) and 42 cases of stable angina pectoris (SAP), and chosen 60 patients with non coronary heart disease were selected as the control group. The differences of ECG and cardiac ultrasound parameters between the two groups were compared. QTV, QTc interval, TpTe, TpTe/QT, left atrial diameter, left ventricular posterior wall thickness, ventricular septal thickness and left 625 ventricular end diastolic diameter in the observation group were significantly higher than those in the control group (P<0.05), while the left ventricular ejection fraction was significantly lower than that in the control group (P<0.05). In observation group the TpTe, TpTe/QT and left atrial diameter of ACS patients were significantly higher than those of SAP patients (P<0.05), while the left ventricular ejection fraction was significantly lower than that of SAP patients (P<0.05). The QTV, QTc interval, TpTe, TpTe/QT and left ventricular end diastolic diameter of patients with severe stenosis in the observation group were significantly higher than those in patients with mild to moderate stenosis (P<0.05), while the left ventricular ejection fraction was significantly lower than those of patients with mild to moderate stenosis (P<0.05). Gensini score was positively correlated with QTV, QTc interval, TpTe and TpTe/QT (P<0.05), but negatively correlated with left ventricular ejection fraction (P<0.05). The area under ROC curve of QTV, QTc interval, TpTe, TpTe/QT combined with left ventricular ejection fraction in predicting severe stenosis was 0.931, P<0.05. The degree of coronary artery stenosis in coronary heart disease is positively correlated with ventricular repolarization index, ventricular repolarization index has a certain value in predicting the degree of stenosis.

Key words: coronary heart disease, degree of coronary artery stenosis, ventricular repolarization index, relevance