运动试验时QT间期离散度诊断冠心病的价值  

Studying on QT dispersion degree of Activity test for the diagnosis value of coronary heart disease

作　　者：蔡晓玉[1] 杨奋[1] 

机构地区：[1]新疆维吾尔自治区人民医院,830063

出　　处：《临床心电学杂志》2014年第2期105-106,共2页Journal of Clinical Electrocardiology

摘　　要：目的探讨QT离散度(QTd)在运动试验中的变化,及其对冠心病心肌缺血的诊断价值。方法 68例临床诊断或疑诊为冠心病的患者先后行平板运动试验(简称运动试验)及冠状动脉造影(简称冠脉造影)检查。结果 47例运动试验阳性者中30例确诊为冠心病;21例运动试验阴性者中19例冠状动脉正常。冠心病组与冠脉正常组运动前、中、后QTd分别为42.38±19.28 ms、70.58±19.45 ms、50.14±13.56 ms及31.18±6.25 ms、30.01±9.05 ms、28.24±8.12 ms,两者比较,p均<0.01。冠心病组运动前、后与运动中QTd比较,差异有显著性,p<0.005;而冠脉正常组QTd变化无显著性。以运动中QTd≥60 ms为异常,诊断冠心病的敏感性为90.9%、特异性100%、准确性94.9%。结论提示运动试验中QTd增加可作为诊断冠心病心肌缺血的敏感而特异的指标。Objective In order to understand the diagnostic value of QT dispersion（QTd） Changes in exercise test for coronary artery disease myocardial ischemia. Methods The clinical diagnosis of 68 cases or suspected coronary artery disease patients have line of treadmill exercise test（referred to as exercise test） and coronary artery（referred to as coronary） angiography. Results 47 cases of positive exercise test in 30 cases diagnosed as coronary heart disease; 21 cases negative exercise test in 19 cases of normal coronary arteries. Coronary heart disease and coronaryarterybeforenormalmovement, duringand afterQTd were42.38 ±19.28 ms, 70.58 ± 19.45 ms, 50.14 ±13.56 ms and 31.18 ± 6.25 ms, 30.01 ± 9.05 ms, 28.24 ± 8.12 ms, between the two（p0.01）. CHD before exercise, after QTd compared with the movement, there was a significant difference（p0.005） whereas normal coronary QTd was no significant change. In sports QTd ≥ 60 ms is abnormal, the sensitivity for the diagnosis of coronary heart disease was 90.9%, specificity 100%, accuracy 94.9%. Conclusions QTd increase in exercise testing can beused asasensitivediagnosisofmyocardialischemiain coronaryheartdiseaseand specifictargets.

关 键 词：平板运动试验 QT离散度 冠心病 心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]