目的 探讨MTWA在扩心病与冠心病患者中的发生状况及MTWA与室性心律失常以及心脏性猝死的关系。方法 选取105例患者，男性85例，女性20例，年龄55.3（23-82）岁，行心电图、心彩超及频谱法MTWA检测并进行随访，以室性心律失常及猝死为终点事件，比较MTWA检测、QT间期离散度、QRS波时限、LVEDD及LVEF与室性心律失常及猝死的相关性。结果 ①105例病人既往或随访中发生终点事件者共18例，其中MTWA检测阳性者13例，不确定性者3例，阴性者2例②用Logistic回归法分析发生室性心律失常及猝死的危险因素，MTWA（OR=5.716），95％置信区间为（1.733,18.850）；用Cox回归模型进行生存分析， MTWA（R∧R=3.923）,95％置信区间为（1.374,11.200）。结论MTWA是扩心病及冠心病患者室性心律失常及猝死发生的独立危险因素，有较高预测价值。

Objective To study the occurrence of Microvolt T-wave alternans in 64 patients with Dilated cardiomyopathy (DCM)and 41patients with Coronary heart disease(CHD), explore the relationship of MTWA and ventricular arrhythmias and sudden death.Methods All the patients were completed the MTWA examination with spectral method using Cambridge Heart. HearwaveTM system. Physical examination, cardiac function classification. 105 patients were enrolled and followed up .Results All the 105 patients who had acceptanced testing were followed up for 3 to 24 months. Set the combination of cardiac death and arrhythmias as the end point .As a result, 18 patients were happened the cardiac death and arrhythmias. MTWA predict the sensitivity of 77.87% and a specificity of 60.91%, non-negative predictive value was 30.43%, negative predictive value was 92.98%.Conclusion MTWA was the risk factor of the combination of cardiac death and arrhythmias in patients with DCM and CHD。

内蒙古自然科学基金