QT-RR间期回归方程中斜率、截距与心室动态复极变化的相关性研究

摘要

目的：探讨健康人群及尖端扭转型室性心动过速（室速）、特发性心室颤动（室颤）人群24 h动态心电监测中，QT-RR间期回归方程中斜率、截距对心室动态复极变化的评价作用。方法入选2014年1月~2015年12月于成都市第三人民医院行24 h动态心电监测检查者，其中健康人群组466例，尖端扭转型室速组7例，特发性室颤组10例，通过QT间期自动分析系统对每份动态心电监测数据进行线性回归分析，计算得出QT-RR间期线性回归方程[QT]= A[RR]+B（A为斜率、B为截距），并对各组中的斜率、截距，进行一元线性回归分析。结果在健康受试者的QT-RR间期线性回归方程中，女性人群斜率明显大于男性（0.185±0.036vs.0.161±0.033，P＜0.001），其截距明显小于男性（0.229±0.028vs.0.240±0.027，P＜0.001）。所有健康受试者线性回归方程中，斜率与截距所组成的散点图显示：两者间存在显著的负相关性（B=-0.62A+0.34，r=-0.79）。健康受试者、尖端扭转型室速与特发性室颤患者线性回归方程斜率与截距所组成的散点分布显示，与健康受试者比较，特发性室颤患者散点图位于健康受试者散点图左上角，尖端扭转型室速患者散点图位于健康受试者上方。结论24 h动态心电监测中，QT-RR间期线性回归方程中斜率与截距指标，能够较有效地预测异常心室复极动态变化情况。%Objective Value of slope and intercept for dynamic changes in ventricular repolarization during QT-RR interval regression equation in healthy people, people with torsade de pointes (TDP) or idiopathic ventricular fibrillation (IVF).Methods This study included 466 healthy subjects and 17 patients with torsade de pointes VT, 10 patients with IVF and 7 patients with TDP received 24-hour dynamic electrocardiogram in the Chengdu Third People’s Hospital from January 2014 to December 2015. The QT-RR interval linear regression equation [QT] = A [RR] + B (A is the slope, B is the intercept) is calculated by linear regression analysis of each dynamic ECG data by QT interval automatic analysis system.Result In the QT-RR interval linear regression equation of healthy subjects, the slope of female was significantly greater than that of male (0.185±0.036vs. 0.161±0.033,P<0.001), and the intercept was significantly less than that of male (0.229±0.028vs. 0.240±0.027,P<0.001). In the linear regression equation of all healthy subjects, the scatter plot of slope and intercept showed a significant negative correlation (B=-0.62A+0.34,r=-0.79). The scatter plot showed that the scatter plot of IVF patients was located in the upper left corner of the scatter gram of healthy subjects compared with healthy subjects, and the scatter plot of TDP patients was located above the healthy subjects.Conclusion In 24-hour ambulatory ECG monitoring, QT-RR interval linear regression equation slope and intercept indicators, can more effectively predict abnormal ventricular repolarization dynamic changes.