QRS波时限延长在冠心病患者运动试验中的意义

The Significance of QRS duration during exercise test in patients with coronary artery disease

目的 探讨冠心病患者运动试验中QRS波时限变化的意义。方法 分析经冠状动脉造影 (冠脉 )证实的6 2例冠心病患者和 16例冠脉造影正常者运动试验前后QRS波时限变化。结果 冠脉正常组运动后QRS波时限较运动前缩短 (P <0 0 5 ) ;冠心病组运动后QRS波时限变化较运动前延长 (P <0 0 1) ;以运动后QRS波时限延长判断为异常 ,诊断冠心病的敏感性为 72 6 % ,特异性为 93 8% ,准确性为97 8%。结论 冠心病患者运动后QRS波时限延长是心肌缺血的一个标志 ,QRS波时限可能是运动试验中诊断冠心病心肌缺血敏感而特异的指标。

Objectives To investigate the significance of QRS duration during treadmill test in patients with coronary artery disease. Methods QRS duration was measured before and after treadmill exercise test in 62 patients with coronary artery disease and 16 patients with normal coronary arteries identified by coronary angiography. Results QRS duration was obviously shorter right after exercise than those before exercise in 16 patients with normal coronary arteries(P<0.05),but prolong in 62 patients with coronary artery disease (P<0.01); Exercise induced QRS duration prolongation was directly related to the number of diseased vessels. QRS prolongation had a diagnostic sensitivity of 72.6%, specificity of 93.8%,accuracy of 97.8%, for diagnosing of coronary artery disease. Conclusions Exercise-induced QRS prolongation in patients with coronary artery disease is a marker of exercise-induced myocardial ischemia; QRS duration during exercise treadmill test could be used as a sensitive and specific index for the diagnosis of coronary artery disease.