[关键词]
[摘要]
目的: 探讨冠状动脉慢血流( CSF) 现象对P 波离散度( Pd) 、QT 离散度( QTd) 及ST 段改变的影响
及与TIMI 帧数值的相关性，作为评价心律失常及心脏性猝死风险增加的一个指标。方法: 入选因疑似冠心病就
诊我院行冠脉造影，示冠脉“正常”者。以TIMI 帧数法评价冠状动脉血流速度，分为慢血流( CSF) 组46 人，正常
血流( NCF) 组47 人，分别测量静息同步12 导心电图的Pd、QTd 及ST 段改变并比较变化。结果: CSF 组病人
Pd、QTd 及QTcd 与NSF 组病人比较均有显著性差异( P＜0．01) ，Pmax、QTmin、ST 段改变与NSF 组病人比较有统
计学差异( P＜0．05) ，而Pmin 及QTmax 两组间无统计学差异。除外Pd 与LAD 无相关性( P = 0．03) 外，两组的
Pd，QTd，QTcd 与TIMI 帧数均有正相关性( P＜0．01) ，ST 段改变LAD、LCX 及TIMI 帧数均值具有正相关( P＜
0．01) ，但与右冠状动脉( ＲCA) 无相关性( P= 0．158) 。其中QTd，QTcd 与三支冠状动脉及TIMI 帧数均值相关关
系密切( r＞0．3) 。结论: CSF 现象可能与心肌缺血有密切的关系。可引起心肌电活动的不均质性改变，在体表心
电图表现为Pd，QTd 及QTcd 值的显著增加。Pd，QTd，QTcd 值的增加与TIMI 帧数值有显著相关性。
[Key word]
[Abstract]
Objective: To investigate the effect of CSF on the change of P wave dispersion( Pd) ，
QT dispersion ( QTd ) and ST segment，and the correlation with TIMI frame values as a possible
predictorr of increased risk for arrhythmia and sudden cardiac death． Methods: The coronary
angiography showed the " normal" of coronary artery disease．In TIMI frame count method to evaluate
coronary artery blood flow velocity，divided into slow blood flow( CSF) group( 46 people) and normal
blood flow( NCF) group of( 47 people) ，measured resting synchronous 12 lead electrocardiogram of Pd，
QTd and ST segment value and compare the change．Ｒesults: CSF group of patients with Pd and QTd
and QTcd compared with NSF groups had significant difference( P＜0．01) ，Pmax and QTmin，ST segment
changes and NSF group patients were compared statistically significant( P＜0．05) ，while Pmin and
QTmax no statistical difference between the two groups． Except for Pd and LAD no correlation ( P =
0．03) ， two groups of Pd，QTd and QTcd and TIMI frame count were positive correlation( P＜0．01) ，ST
segment change LAD，LCX and average TIMI frame count has a positive correlation( P＜0．01) ，but with
the right coronary artery( ＲCA) with no correlation( P = 0．158) ．Among them，QTd and QTcd are closely
related to the mean value of three coronary arteries and TIMI frames( r＞0．3) ．Conclusion: CSF may be
closely related to myocardial ischemia．The heterogeneity of myocardial electrical activity was changed，
and the electrocardiogram showed a significant increase of Pd，QTd and QTcd．Pd，QTd and QTcd value
increase and TIMI frame value have significant correlation．
[中图分类号]
Ｒ543．3
[基金项目]
收稿日期: 2018－01－20; 修回日期: 2018－05－07
基金项目: 内蒙古自治区自然基金项目( 200711020925)
作者简介: 王燕芳( 1981－) ，女，内蒙古自治区人民医院老年心血管内科主治医师，医学硕士。
通讯作者: 韩雅君，主任医师，医学博士，硕士研究生导师，E－mail: junyahan@ sina．com 内蒙古自治区人民医院老年心
血管内科， 010017
