潘生丁负荷试验中QTd诊断冠心病的价值  

QTd in stress test with combined dipyridamole and transesophageal atrial stimulation:Diagnostic value for coronary heart disease

作　　者：王明空[1] 李春生[1] 岳全廷[1] 魏远亮 

机构地区：[1]解放军152医院心内科,河南平顶山467000

出　　处：《心脏杂志》2002年第1期58-60,共3页Chinese Heart Journal

摘　　要：目的 :观察冠心病患者潘生丁试验 (DP- ECG)及潘生丁食管心房调搏复合试验 (TRAS- DP- ECG)前、后心电图 ST段、校正 QT间期 (QTc)及 QT间期离散度 (QTd)的变化 ,以评价 TRAS- DP- ECG诊断冠心病的价值。方法 :对 5 0例冠心病 (CHD)患者 (CHD组 )及 30例正常者 (对照组 )进行 DP- ECG和 TRAS- DP- ECG,记录试验前后 12导联同步心电图 ,测量其 ST段 ,QTc及 QTd。根据分布曲线求出 QTc及 QTd的截断点。分别计算两种试验的敏感度、特异度及准确度。结果 :如以 QTd≥ 40 m s为截断点 ,以 DP- ECG诊断 CHD时 ,其敏感度、特异度、准确度分别为 76 % ,93% ,82 % ;以 TRAS- DP- ECG诊断 CHD时 ,其敏感度、特异度、准确度分别为 92 % ,93% ,92 %。结论 :TRAS- DP- ECG时 ,如以 QTd≥ 40 m s为截断点 ,可明显提高其诊断的敏感度及准确度而不影响其特异度。 QTd≥40 m s可作为 TRAS- DP- ECG时诊断AIM:To assess the value of QTc and QTd combined with ECG in dipyridamole test(DP-ECG) and stress test of combined dipyridamole and transesophageal atrial stimulation(TRAS-DP-ECG) in the diagnosis of coronary heart disease(CHD). METHODS:50 patients with CHD and 40 normal controls underwent DP-ECG and TRAS-DP-ECG. ST segment,QTc and QTd were measured in 12 lead synchronizing ECG recorded before and during the test. The cut-off value of QTc and QTd were calculated on ROC curve. The sensitivity,specificity and accuracy of the two tests were respectively calculated and then compared. RESULTS:Using QTd≥40 ms as the cut-off value,the sensitivity,specificity and accuracy of the diagnosis for CHD in DP-ECG was 76%,93% and 82% respectively,whereas the in TRAS-DP-ECG were 92%,93% and 92% respectively. CONCLUSION:The criteria of QTd≥40 ms during TRAS-DP-ECG might increase the sensitivity and accuracy of the diagnosis of CHD withent significantly decreasing the specificity,which suggests that QTd≥40 ms during TRAS-DP-ECG might be used as an important index in the diagnosis of CHD.

关 键 词：潘生丁食管心房调博复合试验 冠状动脉疾病 QT间期离散度 心电描记术 

分 类 号：R541.404[医药卫生—心血管疾病]