T波形态学参数对冠心病诊断价值的研究

Study on the value of T-wave morphologic parameter for diagnosis of coronary heart disease

关键词:  冠心病  T波形态学  T波峰末间期  QRS-T夹角

Key words:  coronary heart disease  T-wave morphologic parameter  Tp-Te  QRS-T angle

摘要:

目的　研究T波形态学参数对冠心病（CHD）的诊断价值。方法　入选2015年1月至2017年10月于大连医科大学附属第一医院以胸闷、胸痛等心肌缺血症状为主诉住院的患者228例,根据确诊结果分为CHD组143例，非CHD组85例。对两组患者的T波形态学参数（Flat-score、Asym-score、Notch-score、MCS-score、PCA ratio、QTd、QTpeak-d、Tp-Te、QRS-T angle）进行分析研究。结果　CHD组与非CHD组的Asym-score分别为10.13±11.32及13.49±11.65，Tp-Te分别为（110.81±13.43）ms 及（105.32±17.19）ms，QRS-T angle分别为（45.56±26.77）°及（35.46±23.53）°，组间比较差异均有统计学意义，P＜0.05。Tp-Te（AUC:0.631，P=0.001）和QRS-T angle（AUC:0.636，P=0.001）可能用作诊断冠心病的指标，其最佳临界值分别为105 ms及38.5°。结论　Asym-score变小、Tp-Te延长、QRS-T angle增大，可能为CHD的诊断提供一定的参考价值。

Abstract:

Objective　 To study the value of T-wave morphologic parameter for diagnosis of coronary heart disease (CHD). 　Methods　 Totally, 228 patients who were hospitalized with the symptoms of myocardial ischemia such as chest tightness and chest pain were divided into CHD group and non CHD group according to clinical diagnosis. T-wave morphologic parameters (Flat-score, Asym-score, Notch-score, MCS-score, PCA ratio, QTd, QTpeak-d, Tp-Te, and QRS-T angle) of the two groups of patients were compared. 　Results　 Asym-score 10.13±11.32 vs. 13.49±11.65, Tp-Te (110.81±13.43)ms vs. (105.32±17.19)ms, and QRS-T angle (45.56±26.77)° vs. (35.46±23.53)°,all had statistically significant differences between the two groups (P<0.05). Tp-Te (AUC: 0.631, P=0.001) and QRS-T angle (AUC: 0.636, P=0.001) may be used as indicators for the diagnosis of CHD, the best critical values were 105 ms and 38.5°, respectively. 　Conclusion 　Lower Asym-score, longer Tp-Te and larger QRS-T angle have reference values for diagnosis of CHD.