QT团圆度在冠芥蒂患者运动试验中的意义.docVIP

QT离散度在冠心病患者运动试验中的意义 QT离散度在冠心病患者运动试验中的意义 2010-08-02 张群林　葛永贵　王玮　谢莉 张绪国　潘庆敏　陶弘 　　【摘要】　目的　探讨平板运动试验中冠心病患者与冠状动脉正常者QT离散度(QTd)变化的意义。方法　分析经冠状脉动(冠脉)造影证实的13例冠心病患者与17例冠脉造影正常者平板运动试验前、试验中ST段下移0.1 mV以上或出现典型心绞痛症状或达亚极量心率时以及运动后体表12导联心电图QTd变化。结果　运动前、中、后冠心病组QTd分别为46.2±20.1 ms，71.9±20.4 ms及51.2±14.5 ms；而冠状动脉正常组分别为32.3±6.6 ms，30.9±9.2 ms与29.4±8.5 ms，两组相比P均＜0.01；冠心病组QTd运动中与运动前后相比P均＜0.01，而冠脉正常组差异无显著性；以运动中QTd≥60 ms判为异常，诊断冠心病的敏感性为92.3%，特异性100%，准确性96.7%。结论　冠心病患者运动试验中QTd进一步显著增加，QTd是运动试验中诊断冠心病心肌缺血敏感而特异的指标。 　　【关键词】　运动平板试验　　QT离散度　　冠状动脉疾病 The significance of QT dispersion during exercise treadmill test in patients with coronary heart disease 　Zhang Qunlin, Ge Yonggui, Wang Wei, et al. Department of Cardiology, Taihe Hospital, Shiyan, Hubei 442000 　　【Abstract】　Objective　To investigate the clinical significance of QT dispersion during exercise treadmill test in patients with and without coronary artery disease.Methods　QT dispersion of 12-lead surface ECG was measured before, during when ST segments depression was more than 1 mm or typical angina occurred or submaximal heart rate was achieved, and after exercise treadmill test in 13 patients with coronary artery disease and 17 patients with normal coronary arteries identified by coronary angiography.Results　The QT dispersions were significantly increased in patients with coronary artery disease before, during and after exercise (46.2±20.1 ms, 71.9±20.4 ms and 51.2±14.5 ms, respectively) compared with those in patients with normal coronary arteries (32.3±6.6, 30.9±9.2 and 29.4±8.5 ms, respectively), all P0.01. In patients with coronary artery disease, QT dispersions were significantly increased during exercise compared with those before and after exercise (P＜0.005). There were no significant changes in QT dispersion in patients with normal coronary arteries before, during and after exercise. Stress QT dispersion of ≥60 ms had a sensitivity of 92.3%, specificity of 100%, accuracy of 96.7% for the diagnosis of coronary artery disease.Conclusion　Q