【摘要】 目的:探讨在常规运动试验中以时域法微伏级T波电交替(MTWA)筛查冠心病的价值。方法:经冠状动脉(冠脉)造影确诊的冠心病患者152例为冠心病组。对照组为非冠心病者共140例。采用美国GEMarquette Case 800系统MTWA分析程序以时域法连续分析MTWA及最大MTWA时的心率(HR)为频率阈值,并计算MTWA/HR值。结果:冠心病组时域法MTWA、MTWA/HR值明显高于对照组[(22.04±7.22)μV比(10.63±6.71)μV,P<0.01]、(0.21±0.08比0.09±0.06,P<0.01);频率阈值低于对照组[(107.61±12.06)次/分比(126.23±9.42)次/分,P<0.01]。MTWA筛查冠心病的接收者操作特征曲线下面积为0.908(95%可信区间0.87～0.95,P<0.01),最佳切点为11.5μV(敏感性为97.66%,特异性为71.43%);MTWA/HR值筛查冠心病的接收者操作特征曲线下面积为0.934(95%可信区间0.90～0.97,P<0.01),最佳切点为0.12(敏感性为98.03%,特异性为82.86%)。结论:冠心病患者时域法MTWA的幅度明显高于非冠心病者,频率阈值明显降低,MTWA/HR比值可在运动试验中作为冠心病的筛查指标。更多还原

【Abstract】 Objective:To investigate the value of microvolt T wave alternates(MTWA)in screening the patients with coronary artery disease(CAD). Methods:Our research included two groups,CAD group,n=152,the patients were diagnosed by coronary angiography,and Control group,n=140,the patients without CAD.MTWA was detected with GE Marquette Case 800 MTWA analyzing system,the maximum amplitude of MTWA and heart rate(HR)were recorded.MTWA/HR ratio was calculated. Results:MTWA and MTWA/HR ratio were higher in CAD group than that in Control group(22.04±7.22)μV vs.(10.63±6.71)μV and(0.21±0.08)vs.(0.09±0.06),the threshold of HR was lower in CAD group than that in Control group(107.61±12.06)bpm vs.(126.23±9.42)bpm,P<0.01 respectively.The area under curve of MTWA was 0.908(95% CI 0.87～0.946,P<0.01),the optimal cut-off value for screening CAD was 11.5 μV(sensitivity 97.66% and specificity 71.43%).The area under curve of MTWA/HR was 0.934(95% CI 0.90～0.968,P<0.01),the optimal cut-off value for screening CAD was 0.12(sensitivity 98.03% and specificity 82.86%). Conclusion:Threshold of HR is lower and the amplitude of MTWA is higher in patients with CAD than those without CAD,MTWA/HR ratio might be a new tool for CAD screening.更多还原