【摘要】 目的 分析动态心电图QT间期(corrected QT interval, QTc)联合运动平板试验(treadmill exercise testing, TET)对冠心病冠脉血管病变数量的诊断价值。方法 选取安阳市人民医院2021年4月至2023年5月期间收治的96例冠心病患者为研究对象，患者均行动态心电图检查及TET,并记录各项参数，根据冠脉造影结果，将患者分为单支病变组(n=25)及多支病变组(n=71),对比两组患者动态心电图QTc及TET各项参数[T波峰末间期(T peak end interval, Tpe)、微伏级T波电交替(microvolt T wave alternans, MTWA)、ST/心率(heart rate, HR)指数],采用Pearson相关性分析QTc间期、TET各项参数与冠心病冠脉血管病变数量的关系，并以多因素logistic回归分析冠心病冠脉多支病变的影响因素。结果 多支病变组QTc间期、Tpe、MTWA及ST/HR指数均高于单支病变组(P<0.05)。Pearson相关性分析结果显示，动态心电图QTc间期及TET各项参数与冠心病冠脉血管病变数量呈正相关(P<0.05)。多因素logistic回归分析结果显示，QTc间期(OR=1.016,95%CI:1.000～1.031)、Tpe(OR=1.080,95%CI:1.021～1.143)、MTWA(OR=1.143,95%CI:1.030～1.270)及ST/HR指数(OR=6.632,95%CI:1.735～25.345)是冠心病冠脉多支病变的独立危险因素(P<0.05)。ROC曲线分析结果显示，QTc间期、Tpe、MTWA及ST/HR指数联合诊断冠心病冠脉多支病变的曲线下面积(AUC)、特异度及灵敏度分别为0.934、92.96%、84.00%,其中AUC、敏感度均高于单一指标(P<0.05)。结论 动态心电图QTc间期联合TET对冠心病冠脉血管病变数量具有良好的诊断价值。更多还原

【Abstract】 Objective To analyze the diagnostic value of corrected QT interval(QTc) of dynamic electrocardiogram combined with treadmill exercise testing(TET) for the number of coronary artery lesions in coronary heart disease.Methods A total of 96 patients with coronary heart disease admitted to the hospital from April 2021 to May 2023 were selected as the research subjects. All of them received dynamic electrocardiography and TET, and parameters were recorded. Based on coronary angiography results, the patients were divided into single-vessel disease group(n=25) and multi-vessel disease group(n=71). QTc of dynamic electrocardiogram and TET parameters [T peak end interval(Tpe), microvolt T-wave alternans(MTWA) and ST/heart rate(HR) index] were compared between the two groups. Pearson correlation analysis was used to investigate the relationship between QTc interval, TET parameters and the number of coronary artery lesions in coronary heart disease. Multivariatelogisticregression analysis was conducted to identify the factors influencing multi-vessel disease in coronary heart disease.Results QTc interval, Tpe, MTWA, and ST/HR index in the multi-vessel disease group were longer and higher than those in the single-vessel disease group(P<0.05). Pearson correlation analysis results showed that QTc interval of dynamic electrocardiogram and TET parameters were positively correlated with the number of coronary artery lesions in coronary heart disease(P<0.05). Multivariatelogisticregression analysis results showed that QTc interval(OR=1.016, 95%CI:1.000-1.031), Tpe(OR=1.080, 95%CI:1.021-1.143), MTWA(OR=1.143, 95%CI:1.030-1.270), and ST/HR index(OR=6.632, 95%CI:1.735-25.345) were independent risk factors for multi-vessel disease in coronary heart disease(P<0.05). ROC curve analysis results showed that the area under the curve(AUC), specificity and sensitivity of the combination of QTc interval, Tpe, MTWA and ST/HR index for diagnosing multi-vessel disease in coronary heart disease were 0.934, 92.96% and 84.00%. The AUC and sensitivity were higher than those of each indicator(P<0.05).Conclusion QTc interval of dynamic electrocardiogram combined with TET is helpful for diagnosing the number of coronary artery lesions in coronary heart disease.更多还原