T波峰-末间期对心肌梗死患者预后的临床评估.PDFVIP

2010;30(9) 南方医科大学学报(JSouthMedUniv) 窑2169 窑 T波峰-末间期对心肌梗死患者预后的临床评估 林晓明袁杨希立袁刘鹤龄袁赖玉琼渊广东省佛山市第一人民医院心内科袁广东佛山528000冤 摘要院目的 探讨T波峰-末间期(Tpe)对心肌梗死患者预后的价值遥方法 测量分析234例心肌梗死患者的Tpe 和校正 心率后的T 波峰-末间期渊Tpe姨RR 冤袁平均随访32依10月遥 结 随访期间共发生心血管临床事件45 例袁发生率为 19.2%袁临床事件组Tpe尧Tpe RR明显高于非事件组渊P0.001冤遥 经Kaplan-Meier 曲线分析Tpe140ms组临床事件发 姨 生率明显高于Tpe臆140ms组渊P0.001冤遥利用CO 回归单因素分析袁以临床事件为终点袁比例风险比为2.48渊P0.01冤袁利 用多因素CO 回归分析袁在调整年龄尧冠状动脉病变支数袁左室射血分数等因素后比例风险比为2.66渊P0.01冤遥 结论 Tpe与心肌梗死预后关系密切袁是一个独立预测心肌梗死患者心血管临床事件的新指标遥 关键词院心肌梗死 曰T波峰-末间期曰临床事件 中图分类号院R542.2 文献标识码院A 文章编号院1673-4254渊2010冤09-2169-02 ClinicalassessmentofTpeak-endintervalforpredictionofmyocardialinfarction LINXiao-ming袁YANGXi-li袁LIUHe-ling袁LAIYu-qiong DepartmentofCardiovascularDiseases,FoshanFirstPeoplesHospital,Foshan528000,China Abstract:Objective ToassessthevalueofTpeak-endinterval(Tpe)inpredictingmyocardialinfarction(MI). Methods Tpe andTpeak-endinternalaftercorrectingtheheartrate(Tpe RR)weremeasuredandanalyzedin234MIpatients,whowere 姨 followed-upforanaverageof32依10months.ResultsClinicaleventsoccurredin45(19.2%)patientsattheend Tpe RR of 姨 thefollow-up.Tpeand ofthepatientswithclinicaleventsweresignificantlyhigherthanthoseinpatientswithouttheclinical events(P0.001).TheincidenceofclinicaleventsinpatientswithTpe140msweresignificantlyhigherthanthatinpatients withTpe臆140msbyKaplan-Meieranalysis(P0.001).Withclinicaleventastheendpoint,theproportionalhazardsratewas 2.48inunivariateCOXanalysis (P0.01). Aftercontrollingforriskfactors, thehazardsratewas2.66bymultvariateCO regression(P0.01). ConclusionTpeispositivelycorrelatedtotheprognosisofMIandservesasannewindexforpredicting theclinicaleventsinMIpatients. Keywords:myocardialinfarction;Tpeak-endinterval;clinicaleve