平板运动试验Q-Tc等对冠心病的诊断价值

Significance of Q -Tc etc during treadmill exercise test in predicting coronary artery disease

目的:探讨在运动试验中,Q-Tc、Q-Tr和Q-Tcd对冠心病诊断的价值。方法:分析经冠状动脉造影证实的98例冠心病患者与51例非冠心病患者,平板运动试验和运动后即刻体表12导联心电图Q-Tc、Q-Tr和Q-Tcd 变化,及其预测冠心病的准确性。结果:Q-Tc、Q-Tr的敏感性、特异性,阳性预测值及诊断准确率,分别为84%、76%、83%、81%与69%、88%、89%、77%,与ST段降低相比无明显差异,提示其诊断价值相似;与心血管照影资料对照,上述指标能反映冠脉病变程度:Q-Tcd的敏感度低(58%),而特异性高(94%),其诊断准确性(73%) 与其他指标相比无明显差异,故亦有应用价值。结论:运动中Q-Tc,Q-Tr,Q-Tcd与ST段下移标准对冠心病诊断有应用价值。

Objective:To study the diagnosis value of the changes of Q -Tc, Q -Tr and Q -Tcd during treadmill exercise test for coronary heart disease (CHD). Methods; Choose 98 CHD patients and 51 normal persons who have been performed coronary angiography for study the changes of Q -Tc, Q -Tr and Q -Tcd in 12 leads ECG during and after exercise,those paramters were compared between CHD group and normal group. Results:The sensitivity, specificity, predicting value and correct diagnostic rate of the Q -Tc and Q -Tr were 84% , 76% , 83% , 81% and 69% , 88%, 89%, 77% respectively, which were no significant differences compared with ST depression. The Q-Tcd had higher specificity (94%), and less sensitivity (58%) than above parameters. Conclusion:The changes of Q-Tc, Q-Tr and Q -Tcd and ST depression in the exercise test are practical value for coronary heart disease.