心电图J波在预测冠心病心肌缺血中的作用  

Role of J wave on standard ECG in the prediction of myocardial ischemia

作　　者：翟锁玲[1] 刘少稳[1] 洪江[1] Zhai suoling;Liu shaowen;Hong jiang(Shanghai General Hospital,Shanghai,200080,China)

机构地区：[1]上海市第一人民医院

出　　处：《临床心电学杂志》2019年第2期106-108,共3页Journal of Clinical Electrocardiology

摘　　要：目的分析常规12导联心电图中J波对心肌缺血的诊断价值。方法回顾性分析2017~2019年常规心电图含有J波病例,与活动平板试验结果作对比。并分析其临床资料。结果 253例ECG含J波的病例与385例ECG正常不含J波病例作为对照组,行平板运动试验阳性133例,可疑阳性96例,阴性409例。其中,正常心电图含J波83例,平板试验阳性20例,可疑阳性24例,阴性39例;170例心电图异常伴J波者,包含T波低平和倒置,ST段延长和或上斜或水平压低,QT延长或电压增高者,平板试验阳性91例,可疑阳性32例,阴性47例。J波与心肌缺血的关系,与年龄、相关病史,如高血压、高血脂、糖尿病密切相关,正常心电图中出现J波与不含J波相比,运动平板试验结果阳性率和可疑阳性率均有明显差异(p<0.01),有统计学意义,而正常心电图伴J波的存在与异常心电图伴J波的存在,活动平板试验的阳性率有明显的差异,p<0.01,具有统计学意义。结论 J波结合临床病史为有效预测心肌缺血的指标。Objective To study the value of J wave in predicting myocardial ischemia. Methods We retrospectively analyzed 253 cases with J wave on standard 12 lead electrocardiogram(ECG) from 2017 to 2019 and385 cases without J wave on normal 12-lead ECG. All subjects underwent treadmill exercise test. The clinical data were also analyzed. Results In the treadmill exercise test, 133 cases were positive,96 cases were suspected positive,and 409 cases were negative. Among them, 83 cases were with J wave and otherwisely normal ECG. In this subgroup,20 cases were positive, 24 cases were suspected positive and 39 cases were negative in treadmill test. 170 cases were with J wave accompanied by abnormal ECG including low and inverted T wave, prolongation of ST segment or upward inclination or horizontal depression, and prolongation of QT interval. In this subgroup, 91 cases were positive,32 cases were suspected and 47 cases were negative in treadmill test. There was significant difference between the two subgroups(p<0.01). The relationship between J-wave and myocardial ischemia was closely related to age, history of related diseases such as hypertension, hyperglycemia and hyperlipidemia. There was no significant difference between normal ECG with J-wave and with out J-wave. The positive rate of exercise test were significantly different between normal ECG and abnormal ECG with J-wave.(p<0.01). Conclusions J wave combined with clinical history is an effective indicator of myocardial ischemia.

关 键 词：常规体表12导联心电图 J波 平板运动试验 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]