无创性心电技术在心脏性猝死预测中的应用

摘要

Sudden cardiac death (SCD) has the features of sudden attack,rapid progress,and high fatality rate, w hich is a public health problem that severely threatens hum an health.H ow to identify the population in SCDhigh risk state and adopt tim ely and effective precautionary m easures is key to reducing sudden death .A t present,noninva-sive ECG technique for SCDprediction has m any indexes,and each detection has its advantages,w hich can provide reference inform ation for SCDprediction from different aspects,but all have deficiency or defect of various degrees. N one of the indexes can give accurate and reliable prediction for SCD.SCDis not a single em ergency but a result of com bined action of various factors such as ischem ia level,left ventricular function ,cardiac m uscle scars,and arrhyth-m ia strom a.Pathogenesis of SCD(abnorm al cardiac m uscle strom a,abnorm al cardiac m uscle repolarization,instable electrical activity,and abnorm al autonom ic nervous function) should be considered to screen predictive param eters, com bined application of m ultiparam eters is likely to be key to im proving the predictive accuracy of SCD.%心脏性猝死( SCD )发病突然、进展迅速、病死率高，是严重威胁人类健康的公共卫生问题，如何识别处于猝死高危状态的人群并采取及时有效的预防措施是减少猝死发生的关键。目前用于SCD预测的无创性心电学指标众多，每项检测都有各自的优势，可从不同的侧面为SCD的预测提供参考信息，但均存在不同程度的不足或缺陷，尚无一项指标能够对SCD做出准确可靠的预测。SCD并非单一突发事件，而是由缺血程度、左心室功能、心肌瘢痕以及心律失常基质的存在等各种因素综合作用的结果。应从SCD的发生机制(心肌基质异常、心肌复极异常及电活动不稳定、自主神经功能异常)来筛选预测参数，多参数联合应用可能是提高SCD预测准确性的关键。