食道心房超速负荷试验中QT间期离散度诊断冠心病的价值  

The diagnosis value of QTd in transesophageal atrial superrate stimulation stress test for coronary heart disease

作　　者：王明空[1] 李春生[1] 岳全廷[1] 魏运亮[1] 

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3期226-228,共3页Chinese Heart Journal

摘　　要：目的 :评价食道心房超速负荷试验的 QT间期离散度 (QTd)诊断冠心病的价值。方法 :对 32例冠心病患者 (冠心病组 )及 34例正常者 (对照组 )进行食道心房超速负荷试验 ,记录试验前后 12导联同步心电图 ,测量其 ST段、校正 QT间期 (QTc)及 QTd。根据 ROC曲线求出 QTc及 QTd的截断点 ,以冠脉造影为诊断冠心病的标准诊断方法 ,利用四格表法 ,分别计算各观测指标的特异度及敏感度。并与“并联试验”相互比较。结果 :ST段下移、QTc,QTd诊断冠心病的特异度分别为 10 0 % ,6 8% ,94% ;敏感度分别为 5 3% ,78%和 84%。 ST段下移和 QTd并联试验时敏感度可达 94%。结论 :食道心房超速负荷试验时 ,如以传统的诊断指标 ST段下移 ,结合 QTd,可明显提高其诊断的敏感度 。AIM:To evaluate the value of QTc and QTd combined with ECG in transesophageal atrial superrate stimulation stress test in the diagnosis of coronary heart disease.METHODS:32 patients with coronary heart disease and 34 normal controls were undergone transesophageal atrial superrate stimulation stress test. ST segment,QTc and QTd were measured in 12 lead synchronizing ECG recorded before and during the test. Using statistic crosstab method,the specificity and sensitivity of each criterion were calculated according to the cut-off point on ROC curve of QTc and QTd combined with the diagnostic criteria of coronary artery angiography. This was also compared with the method of 'combining diagnostic criteria'. RESULTS:It showed that using ST segment depression, QTc and QTd as positive diagnostic criteria of coronary heart disease in transesophageal atrial superrate stimulation stress test, the specificity of above criteria was 100%,68% and 94%,respectively,and the sensitivity,53%,78% and 84%,respectively. By combining the diagnostic criteria of ST segment depression with that of QTd,the sensitivity was 94%. CONCLUSION:It suggested that the traditional criteria of ST segment depression combined with QTd during transesophageal atrial superrate stimulation stress test might increase the sensitivity of the diagnosis of coronary heart disease,it might be used as an important index in the diagnosis of coronary heart disease.

关 键 词：食道心房超速负荷试验 冠心病 QT间期离散度 心电描记术 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]