【作者】 康宏；

【导师】 张钲；

【作者基本信息】 兰州大学 ， 内科学， 2008， 硕士

【摘要】 目的研究陈旧性心肌梗死(简称心梗)患者的微伏级T波电交替(MTWA),旨在探讨MTWA的临床意义。方法平板运动试验过程中利用渐量修正技术监测陈旧性心梗患者83例(Ⅰ组,依试验过程中有无室性心律失常发生分为Ⅰa、Ⅰb组),健康人群90例(Ⅱ组)的MTWA,分析各组之间MTWA的差异及MTWA与心梗部位的相关性。结果①各导联组间MTWA除aVR导联三组间无差异外,余导联均有差异;②Ⅰa组与Ⅱ组除aVL导联外余各导联MTWA值无差异(P＞0.017);Ⅰa组与Ⅰb组Ⅱ、Ⅲ、aVF导联MTWA值有差异(P＜0.017),余各导联MTWA值无差异(P＞0.017);Ⅱ组与Ⅰb组各导联MTWA值有差异(P＜0.017)。③Ⅰb组不同部位心梗的相关导联MTWA值有差异。结论运动平板试验中利用渐量修正技术监测MTWA可作为陈旧性心肌梗死患者发生恶性室性心律失常危险分层的指标。更多还原

【Abstract】 Objective To investigate clinical importance of the microvolt T wave alternans(MTWA)in post myocardial infarction(post-MI)patientsMethods MTWA test with MMA(Modified moving average analysis)was performed in post-MI patients(n=83),comprised group Ia,there is no ventricular arrhythmia during exercise treadmill test and group Ib,ventricular arrhythmia detected during the test.90 healthy individuals were taken as control(groupⅡ).Difference of MTWA in each group and the relationship between the MTWA value and the infarcted region were analysed.Results(1)Value difference of each leads reached statistical significancy in three groups except aVL.(2)Except avL,there was no statistical difference in group Ia andⅡon the MTWA value(P＞0.017),but it reached statistical significance between Ia and Ib group inⅡ,Ⅲ,avF leads(P＜0.017).The difference betweenⅡgroup and Ib group in all leads got statistical significance(P＜0.017);(3)In Ib group,different infarction walls showed different MTWA values on correlated ECG.Conclusion MTWA measurement through exercise treadmill test is a promising approach for risk stratification for malignant ventricular arrhythmia in relatively low-risk post-MI patients.更多还原