摘要
目的探索阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并夜间频发室性早博(PVC)患者心电图心室复极化指标的变化及其预测价值。方法回顾性分析首次确诊为OSAHS并未行治疗的患者509例,根据动态心电图结果,符合夜间频发PVC的患者纳入OSAHS+PVC组(45例),匹配同期初诊为OSAHS且无心律失常的患者(45例)为OSAHS组。分析患者的一般病历资料和心电图中的Tp-e间期、Tp-e与QT的比值(Tp-e/QT)、校正QT间期(QTc)、Tp-e与QTc的比值(Tp-e/QTc)和QT间期离散度(QTd)等指标。结果OSAHS+PVC组患者的Tp-e、Tp-e/QT、Tp-e/QTc、QTd明显高于OSAHS组(均P<0.05)。单因素回归分析发现Tp-e、Tp-e/QT、Tp-e/QTc、QTd是OSAHS患者夜间发生PVC的危险因素。多因素回归分析和ROC曲线分析发现,Tp-e/QT升高和QTd延长与OSAHS患者夜间频发PVC的相关性最强(均P<0.01),Tp-e/QT的曲线下面积最大(0.901)。结论代表心室复极化异常的心电图指标,包括Tp-e、Tp-e/QT、Tp-e/QTc、QTd在OSAHS相关夜间频发PVC患者中显著升高。Tp-e/QT升高和QTd延长是OSAHS相关夜间频发PVC的重要危险因素,而Tp-e/QT延长对OSAHS相关夜间频发PVC有较好的预测价值。
Objective To explore the changes of ventricular repolarization index and its predictive value in patients with ob-structive sleep apnea hypopnea syndrome(OSAHS)complicated with frequent nocturnal remature ventricular contractions(PVC).Methods Patients diagnosed with OSAHS for the first time without treatment were retrospectively analyzed(509 ca-ses).According to the results of ambulatory electrocardiogram,patients with frequent PVC at night were included in the OS-AHS+PVC group(n-45),and patients with OSAHS and no arrhythmias were matched with the OSAHS group(n=45).The.general medical records of patients and the indicators of Tp-e interval,ratio of Tpre to QT(Tpre/QT),corrected QT interval(QTc),ratio of Tp-e to QTe(Tp-e/QTc)and QT interval dispersion(QTd)in the ECG were analyzed.Results Tp-e,Tp-e/QT,Tp-e/QTc and QTd in OSAHS+PVC group were significantly higher than those patients in OSAHS group(P<0.05).Univa-riate regression analysis found that Tpre,Tp-e/QT,Tp-e/QTc and QTd were the risk factors of nocturnal frequent PVC.Multivariate regression analysis and ROC curve analysis found that the prolonged Tp-e/QT and QTd had the strongest correlation with nocturnal frequent PVC in OSAHS patients(P<0.01),and the area under the curve of Tpre/QT was the lar-gest 0.901(0.834-0.968).Conclusion ECG indexes representing abnormal ventricular repolarization,including Tpre,Tp-e/QT,Tp-e/QTc,and QTd,were significantly elevated in patients with OSAHS related nocturnal frequent PVC.Prolonged Tp-e/QT and QTd are significant risk factors of OSAHS related nocturnal PVC,and prolonged Tp-e/QT has a good predictive value for OSAHS related nocturnal frequent PVC.
作者
黄兵
闫慧
周纪宁
幸世峰
龙庆红
Huang Bing;Yan Hui;Zhou Jining(Department of Card iovascular Medicine,People's Hospital of Wuhan University,Wuhan 430060,China;Department of Cardiovascular Medicine,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2023年第4期535-539,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
湖北省自然科学基金资助项目(No.2021CFB440,No.2021CFB334)。
