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目的采用12导联高分辨率动态心电图(12-HR-HOLTER)对冠心病患者及非冠心病患者作12-HR-HOLTER记录并进行微伏级(uV)TWA时域及频域检测分析,探索12-HR-HOLTER的TWA检测方法和评价指标。方法选择冠心病患者170例为Ⅰ组,其中男112例,女58例,平均年龄64.49±11.68岁,高血压患者114例为Ⅱ组,其中男45例,女69例,平均年龄63.09±12.57岁,及非心血管病患者67例为Ⅲ组,其中男30例,女37例,平均年龄61.37±9.59岁,分别记录12-HR-HOLTER,并进行TWA检测分析。结果①冠心病组(Ⅰ组)TWA事件明显高于高血压组(Ⅱ组)及非心血管病组(Ⅲ组,177.97±794.99,0.70±2.56,0.63±1.92,p<0.01);②TWA事件主要检测指标为TWA发生阵/次(TWA-E),TWA持续时间(TWA-HOUR)及TWA心搏数(TWA-BEAT);Ⅰ组TWA事件各项指标均明显高于Ⅱ、Ⅲ组(p<0.01);③Ⅱ组及Ⅲ组检出少量TWA事件,二组间各项TWA检测指标均无显著性差异(p>0.05),冠心病组(Ⅰ组)TWA阳性率(16.47%)明显高于Ⅱ、Ⅲ组(0.88%,1.49%,p<0.01)。结论①12-HR-HOLTER记录检测分析方法可对微伏级TWA进行频域和时域检测分析;②冠心病患者TWA的发生率明显高于高血压患者及非心血管病患者;③TWA发生阵/次(TWA-EVENT)、TWA持续时间(TWA-HOUR)及TWA心搏数(TWA-BEAT)等参数可作为TWA检测评价的定量指标。
Objective To perform 12-HR-HOLTER recording of 12-lead high resolution Holter monitoring (ECG) and non-coronary heart disease (CHD) Explore 12-HR-HOLTER TWA detection methods and evaluation indicators. Methods 170 patients with coronary heart disease were selected as group Ⅰ, including 112 males and 58 females, with an average age of 64.49 ± 11.68 years and 114 hypertensive patients as group Ⅱ, including 45 males and 69 females, with an average age of 63.09 ± 12.57 67 patients of age and non-cardiovascular disease were Group Ⅲ, including 30 males and 37 females, with a mean age of 61.37 ± 9.59 years. 12-HR-HOLTER was recorded and analyzed by TWA. Results ① The incidence of TWA in CHD group was significantly higher than that in hypertension group (group Ⅱ) and non-cardiovascular group (group Ⅲ, 177.97 ± 794.99,0.70 ± 2.56,0.63 ± 1.92, p <0.01) The main parameters of TWA were TWA-TW, TWA-HOUR and TWA-BEAT. The indexes of TWA in group Ⅰ were significantly higher than those in group Ⅱ and Ⅲ (P <0.01) .③Two small amount of TWA events were detected in groupⅡand groupⅢ, there was no significant difference between the two groups (p> 0.05), and the positive rate of TWA in groupⅠ (16.47%) was obvious Higher than those in group Ⅱ and Ⅲ (0.88%, 1.49%, p <0.01). Conclusions ①12-HR-HOLTER recording and analyzing method can detect and analyze the micro-volt TWA in frequency and time domain. ② The incidence of TWA in patients with coronary heart disease is significantly higher than that in hypertensive patients and non-cardiovascular patients. ③TWA / TWA-EVENT, TWA-HOUR and TWA-BEAT can be used as quantitative indicators for TWA test.