目的本文通过分析平板运动试验中
空间QRS-T夹角与空间Tp-Te间期的动态变化以及它们之间的相关性
为心脏危险因素提供新的预测方向。方法入选2013年10月到2014年1月于大连医科大学附属第一医院行平板运动试验检查的成年人40例
所有受试者均排除先天性心脏病、器质性心脏病
收集正常健康人群平板运动试验中不同时段QRS-T夹角和Tp-Te间期
并且在接受平板运动试验前均未服用影响心率的药物
各组患者在年龄、性别方面差异无统计学意义
具有可比性。连续同步检测体表12导联心电图并分别在运动前、运动结束、运动结束后1、4、9min采集心电向量图。分析运动前、运动结束以及运动结束后第1、4、9min的QRS-T夹角和Tp-Te间期的动态变化
以及二者的相关性。结果 (1)运动不同时程的QRS-T夹角动态变化的均值与标准差:运动前7.23±3.58
p<0.05;运动结束9.87±4.64
p<0.05;运动结束后1min 9.56±4.35
p<0.05;运动结束后4min 8.29±4.26
p<0.05;运动结束后9min 8.27±4.50
p<0.05。单因素方差分析和多重比较表明QRS-T夹角运动前、运动结束、运动结束后1min各组间变化最显著
差异具有统计学意义。QRS-T夹角随时间变化较Tp-Te间期更敏感;(2)运动不同时程Tp-Te间期动态变化的均值与标准差:运动前1.67±2.75
p<0.05;运动结束1.74±2.63
p<0.05;运动结束后1min 1.76±2.29
p<0.05;运动结束后4min 1.77±1.63
p<0.05;运动结束后9min 1.79±1.73
p<0.05。单因素方差分析表明Tp-Te间期各组间不具有统计学差异;(3)通过Pearson相关
对各组QRS-T夹角和Tp-Te间期进行相关性分析:其中各组Pearson R值和p值分别为:运动前(R=0.089
p>0.05)、运动结束(R=-0.063
p>0.05)、运动结束后1min(R=0.096
p>0.05)、运动结束后4min(R=-0.255
p>0.05)、运动结束9min(R=-0.041
p>0.05)。各分组R均小于0.8
p均大于0.05
差异无统计学意义
二者没有相关性。校正前、后全部(不分组)QRS-T夹角与Tp-Te间期进行相关性分析
p均大于0.05
差异无统计学意义
二者没有相关性。结论 (1)平板运动试验中截取的空间QRS-T夹角在运动前、运动结束、运动结束后1min
各分组之间存在显著性差异
具有统计学意义;(2)平板运动试验中截取的空间Tp-Te间期在运动前、运动结束、运动结束后1、4、9min各分组之间差异不具有统计学意义;(3)空间QRS-T夹角较空间Tp-Te间期随时间变化更敏感
空间QRS-T夹角与空间Tp-Te间期不具有相关性。
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