摘要
目的 通过活动平板试验前后冠心病患者与冠状动脉正常者的 QT离散度变化 ,研究运动引起的心肌缺血对 QT离散度的影响。 方法 分析经冠状动脉造影证实的 41例冠心病患者与 45例冠状动脉造影正常者活动平板试验前和运动高峰时体表 12导联心电图 QT离散度变化。 结果 运动前 ,运动高峰冠心病组 QT离散度分别为 (47.84± 11.19) m s,(6 2 .16± 10 .45 ) ms(P<0 .0 0 1) ;而冠状动脉造影正常者分别为 (2 4.2 2± 15 .15 ) ms,(2 3.11± 14.43) ms(P>0 .0 5 ) ,运动前、后两组相比 P均 <0 .0 0 1。以运动中 QT离散度≥ 5 0 m s判为异常 ,诊断冠心病的敏感性 86 .2 % ,特异性 88.9% ,预测准确性 87.5 %。 结论 冠心病组活动平板试验中 QT离散度进一步增加 ,冠状动脉造影正常组 QT离散度无变化 ,提示运动高峰时较大的 QT离散度有助于反映冠状动脉病变及心肌缺血程度。并提示 QT离散度是活动平板试验中诊断冠心病心肌缺血敏感而特异的指标。
Objetive The purpose of this study was to investigate the effect of exercise induced ischemia on QT dispersion(QTd) in patients with coronary heart disease (CHD). Methods The changes of QTd of 12 lead surface ECG measured before and at peak exercise treadmill test (ETT) were analysed in 51 patients with CHD and 45 patients with normal coronary arteries identified by coronary angiography. Results ①In CHD group,the QTd was prolonged from [(47 84±11 19) ms to (62 16±10 45) ms(P<0 001)]at peak excercise test (ETT).In contrast,no significant difference was found in QTd before and at peak ETT in control group[(24 22±15 15) ms vs (23 11±14 43) ms,P>0 05];②Stress QTd≥50 ms had a sensitivity of 86 2%,specificity of 88 9%,accuracy of 87 5%,for the dignosis of CHD. Conclusion QTd was significantly increased in patients with CHD during ETT.A larger QTd at peak exercise may reflect the extent of myocardial ischemia.QTd during ETT could be used as a sensitive and specific index for the diagnosis of CHD.
出处
《中华心律失常学杂志》
2000年第2期114-116,共3页
Chinese Journal of Cardiac Arrhythmias
