摘要 目的 分析心肌致密化不全(noncompaction of ventricular myocardium, NVM)儿童T波峰末间期(Tp-Te)、校正的Tp-Te间期（Tp-Tec）、Tp-Te与QT间期的比值(TpTe/QT)等心肌复极指标的变化及其临床意义。方法 收集34例住院NVM患儿作为NVM组，随机选取健康儿童34例作为对照组，比较两组12导联体表心电图心率、校正的QT间期（QTc）、Tp-Te、Tp-Tec及Tp-Te/QT等指标。[HTH]结果[HTK] 34例NVM患儿中5例（14.7%）并发室性心律失常（室性早搏4例，室性心动过速1例）。NVM组心率较对照组明显加快，差异有统计学意义[(128.8±21.8)次/min vs. (113.1±17.5)次/min，P<0.05]。两组QTc、Tp-Te比较，差异均无统计学意义[(404.8±30.9)ms vs. (402.6±21.4)ms，(76.1±17.3)ms vs. (72.1±13.9)ms，P均＞0.05]。NVM组与对照组比较，Tp-Tec明显延长，Tp-Te/QT明显升高，差异均有统计学意义[(112.7±26.8)ms vs. (98.6±16.6)ms，(0.27±0.06) vs. (0.23±0.04)，P均<0.05]。结论 儿童NVM存在跨室壁复极离散度的异常，易导致室性心律失常的发生。由于心率等因素的影响，Tp-Tec、Tp-Te/QT对儿童NVM发生室性心律失常的预测价值高于Tp-Te.
Abstract：Objective To analyze the changes and clinical significance of T peakT end interval(Tp-Te), corrected Tp-Te(Tp-Tec), the ratio of Tp-Te and QT interval(Tp-Te/QT), and other myocardial repolarization indexes in children with noncompaction of ventricular myocardium(NVM). Methods Thirty-four hospitalized children with NVM were enrolled in our study as NVM group while another 34 healthy children were randomly selected as the control group. We compared the heart rate measured from 12 lead surface electrocardiogram, corrected QT interval(QTc), Tp-Te, Tp-Tec, Tp-Te/QT and other indexes between the two groups. Results Five(14.7%) out of the 34 NVM children were complicated by ventricular arrhythmia(4 cases of premature ventricular contraction and one case of ventricular tachycardia). The heart rate of children in NVM group was significantly higher than those in the control group, with statistically significant difference[(128.8±21.8) times/min vs. (113.1±17.5) times/min, P<0.05]. There was no significant difference in either QTc or TpTe between the two groups[(404.8±30.9) ms vs. (402.6±21.4) ms, (76.1±17.3) ms vs. (72.1±13.9) ms, P＞0.05]. In NVM group, Tp-Tec was prolonged and Tp-Te/QT increased significantly if compared with those indexes in the control group, with statistically significant differences[(112.7±26.8) ms vs. (98.6±16.6) ms, (0.27±0.06) vs. (0.23±0.04), P<0.05]. Conclusion The abnormalities of transmural dispersion of repolarization in children with NVM easily lead to the occurrence of ventricular arrhythmia. Because of the influence of heart rate and other factors, the predictive value of Tp-Tec and Tp-Te/QT on ventricular arrhythmia in children with NVM is higher than that of Tp-Te.
孙东明, 张勇, 王瑞耕, 蒋小梅. 儿童心肌致密化不全Tp-Te、Tp-Tec、Tp-Te/QT的变化[J]. 实用心电学杂志, 2017, 26(3): 187-189.
SUN Dong-Ming, ZHANG Yong, WANG Rui-Geng, JIANG Xiao-Mei. The changes of Tp-, Tp-Tec and Tp-Te/QT in children with noncompaction of ventricular myocardium. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2017, 26(3): 187-189.
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