QT离散度测定的重复性和正常值的研究.docVIP

???? QT离散度测定的重复性和正常值的研究 ???? ???? 摘要　为评价QT离散度(QTd)测定的重复性和制定正常值范围，采用同步十二导联心电机测量100例正常人和50例心肌梗死患者的QTd，分析QTd在不同纸速时测量的重复性情况，以及测量QTd正常值范围。结果：正常人心电以同步50 mm/s纸速记录时QTd的重复性较好，此时一人两次(Intraobserver)和两人一次(Interobserver)测量的相关系数分别为0.85，0.75(P均＜0.05)。心肌梗死患者的QTd重复性以同步25 mm/s纸速记录时为佳，在Intraobserver和Interobserver的相关系数分别为0.75，0.68(P均＜0.05)。100例正常人在同步50 mm/s纸速下记录心电测定的QTd为27±12 ms，95％分布范围为3～51 ms。QTd在男、女性别及各年龄段之间差异无显著性。结果提示用不同走纸速度测量正常和异常心电的QTd有助于提高其重复性。QTd＜50 ms为正常范围。关键词　QT离散度　心电描记术　重复性 The Study on Variability of QT Dispersion Measurements and the Normal Value Huang Ying,Wang Zhoubi,Chen Yunzhen(Department of Cardiology,The First Affiliated Hospital of Chongqing Universityof Medical Science,Chongqing,400016) Abstract　To evaluate the variability of repeated QT dispersion (QTd) measurements and the range of normal value,simultaneous standard 12-lead surface electrocardiogram (ECG) tracings were obtained in 100 normal subjects and 50 myocardial infraction patients.The reproducibility of QTd was assessed with different paper speeds and the normal rangs was analysed.Results:The reproducibility of QTd in normal ECGs was better when being recorded simultaneously at 50 mm/s.The correlation coefficient in intraobserver and interobserver were 0.85,0.75 respectively,P＜0.05.It was better in mycardial infraction patients when being recorded at 25 mm/s and the correlation coefficient in intraobserver and interobserver were 0.75,0.68 respectively,P＜0.05.The values of QTd obtained in 100 normal persons in 12-lead synchrony ECGs at 50 mm/s averaged 27±12 ms,with a 95％ range of 3～51 ms.There were no differences between sexes and among ages.Conclusions:The measurements of QTd with different paper speeds in normal and abnormal ECGs help to improve its reproducibility.QTd50 ms could be regarded as normal range.Key words　QT dispersion　Electrocardiography　Reproducibility 　　QT离散度(QT dispersion,QTd)是指体表心电十二导联中最大QT间期与最小QT间期之间的差值［1］。QTd反映心室复极的不一致性，已被广泛用作预测心脏病室性心律失常的指标。因而QTd测量的准确性和重复性是临床应用的基础。本文采用同步十二导联记录心