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目的 探讨国人微伏级T波电交替 (microvoltTwavealternanstest,MTWA)试验的正常参考值。方法 频谱法检测 4 4例健康志愿者微伏级T波电交替 ,分析交替压 (alternansvoltage ,Valt)的大小及其与性别、心率 (HR)的关系。结果 (1)正常中青年国人T波电交替压大小与性别无关 (P >0 0 5 )。 (2 )HR <90 /min时 ,Valt均值 <1 0 μV ,95 %可信区间 0 4 5～ 1 0 2 μV ;90 /min≤HR≤ 110 /min时 ,Valt均值 <1 9μV ,95 %可信区间 1 4 7～ 2 0 8μV ;HR>110 /min时 ,Valt可 >1 9μV ,95 %可信区间 1 5 2～ 2 4 1μV。各组间比较 ,Valt差异有非常显著性意义 (P均 <0 0 1)。尤以综合导联及胸前导联差异有显著性 (P均 <0 0 1)。 (3)随心率增加 ,交替压增大 ,心率与综合导联Valt有相关性 (r=0 4 94 ,P <0 0 1)。结论 微伏级T波电交替具有频率依赖性。运动试验方案测定T波电交替 ,正常中青年国人 90 /min≤HR≤ 110 /min时 ,正交导联及综合导联Valt<1 9μV ,胸前导联Valt<2 0 μV。
Objective To investigate the normal reference values of microvolt T wave alternans test (MTWA) Methods The frequency of alternating voltage (alternansvoltage, Valt) and its relationship with gender and heart rate (HR) were analyzed by spectral method. Results (1) There was no correlation between T-wave alternation and normal sex in normal young people (P> 0.05). (2) Valt mean <1 0 μV, 95% confidence interval 0 4 5 ~ 1 0 2 μV when HR <90 / min; The confidence interval ranged from 147 to 280 μV; for Val> 110 / min, Valt was> 19 μV and 95% confidence interval was from 125 to 241 μV. There was significant difference in Valt between groups (P <0.01). Especially in the lead and chest lead difference was significant (P all <0.01). (3) As the heart rate increased, the alternating pressure increased. The heart rate was correlated with the Valt of the lead (r = 0.944, P <0.01). Conclusion Micro-volt T-wave alternation has frequency dependence. Exercise test program to determine the T wave alternating normal young people 90 / min ≤ HR ≤ 110 / min, the orthogonal lead and the integrated lead Valt <1 9μV, chest lead Valt <20 μV.