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目的探讨基于动态心电图记录的时域法T波电交替(TWA)检测方法及其对老年急性心肌梗死(AM I)患者住院期间心室颤动的预测价值。方法1998~1999年来自北京朝阳医院的72例老年AM I患者,依据住院期间有无心室颤动分为室颤组(12例)和非室颤组(60例)。应用时域法测量TWA指标,分析TWA预测室颤的敏感性、特异性及预测值。结果非室颤和室颤两组之间的TWA有显著性差异(P<0.05),TWA>60μV预测老年AM I患者室颤的敏感性为83%、特异性81%、阳性预测值63%、阴性预测值93%。结论时域法测量的老年AM I患者的早期TWA对住院期间室颤有预测价值。
Objective To investigate the time domain T wave alternating current (TWA) detection method based on Holter recording and its predictive value for ventricular fibrillation in elderly patients with acute myocardial infarction (AMI). Methods Seventy-two elderly AMI patients from Beijing Chaoyang Hospital from 1998 to 1999 were divided into two groups according to the presence or absence of ventricular fibrillation during hospitalization: ventricular fibrillation (12 cases) and non-ventricular fibrillation (60 cases). The time domain method was used to measure the TWA index, and the sensitivity, specificity and predictive value of TWA in predicting ventricular fibrillation were analyzed. Results There was a significant difference in TWA between non-VF and VF (P <0.05). TWA> 60μV predicted 83% sensitivity, 81% specificity and 63% positive predictive value for ventricular fibrillation in elderly AMI patients. Negative predictive value of 93%. Conclusion Early TWA measured by time-domain method in elderly AMI patients has predictive value for ventricular fibrillation during hospitalization.