Tp-e间期、P波离散度对室性心律失常病情的预测价值

摘要 目的：探讨Tp-e间期、P波离散度(Pd)对室性心律失常病情的预测价值。方法：2016年6月到2018年6月选择在本院诊治的心绞痛患者110例，所有患者都给予动态心电图检查，记录Tp-e间期、Pd值与室性心律失常发生情况。随访患者的心绞痛复发情况，并判定预测价值。结果：在110例患者中，发生室性心律失常48例(失常组)，发生率为43.6 %，其中偶发室早21例、频发室早19例、室早4例、心室颤动3例、室性心动过速1例。失常组的Tp-e间期、Pd值都显著高于非失常组(P<0.05)。随访至今，失常组的心绞痛复发率为45.8 %，显著低于对照组的8.1 %(P<0.05)。在失常组中，单因素与多因素logistics回归分析显示Tp-e间期、Pd都为影响患者心绞痛复发的重要因素(P<0.05)。ROC曲线分析显示Tp-e间期、Pd预测心绞痛复发的敏感性与特异性都在85.0 %以上。结论：心绞痛合并室性心律失常患者多伴随有Tp-e间期、Pd增加，也会增加患者的复发率，Tp-e间期、Pd对预测室性心律失常复发情况具有重要价值。

Predictive Value of Tp-e Interval and P Wave Dispersion in Ventricular Arrhythmia

ABSTRACT Objective: To explore the predictive value of Tp-e interval and P wave dispersion (Pd) for ventricular arrhythmia. Methods: From June 2016 to June 2018, 110 patients with angina pectoris diagnosed and treated in our hospital were selected as the research objects. All patients were given Holter examination, and the Tp-e interval, Pd value and occurrence of ventricular arrhythmia were recorded. Follow up the patient''s angina pectoris recurrence and determine the predictive value. Results: Among 110 patients, 48 cases of ventricular arrhythmia occurred (arrhythmia group), with an incidence rate of 43.6 %, including 21 cases of occasional ventricular early, 19 cases of frequent ventricular early, 4 cases of ventricular early, and 3 cases of ventricular fibrillation. 1 case of ventricular tachycardia. The Tp-e interval and Pd value of the abnormal group were significantly higher than those of the non-abnormal group (P<0.05). Since follow-up, the recurrence rate of angina pectoris in the abnormal group is 45.8 %, which is significantly lower than 8.1 % in the control group (P<0.05). In the abnormal group, univariate and multivariate logistics regression analysis showed that Tp-e interval and Pd are important factors affecting the recurrence of angina pectoris (P<0.05). ROC curve analysis showed that the sensitivity and specificity of Tp-e interval and Pd in predicting the recurrence of angina pectoris were above 85.0 %. Conclusion: Patients with angina pectoris complicated with ventricular arrhythmia usually have increased Tp-e interval and Pd, which will also increase the recurrence rate of patients. Tp-e interval and Pd have important value in predicting the recurrence of ventricular arrhythmia.