运动负荷试验P波时间及振幅动态变化临床意义探讨

APPOACH TO THE CLINICAL SIGNIFICANCE OF THE DYNAMIC CHANGE OF P WAVE TIME AND AMPLITUDE IN THE EXERCISE LOAD TEST

对７２例疑为冠心病患者进行运动心电图负荷试验，观察Ｐ波时间及振幅的动态变化。结果：７２例受试者Ｓ─Ｔ段呈缺血性改变者３５例，Ｐ波振幅增高在１．０～１．８ｍｍ者８例（１１．１％），Ｔ、Ｐ等高并部分融合７例（９．７２％）；Ｐ≥Ｒ，７例（９．７２％）。Ｐ波出现切迹、双峰间距＞０．０４ｓ４例。主要表现在Ⅱ、Ⅲ、ａｖＦ导联。在３５例运动负荷试验阳性中，Ｐ波动态变化者７例，占２０％。结论：运动负荷试验后出现Ｐ波时间及振幅的变化，是反映心房异常的一项敏感指标，可有助于冠心病及高血压性心脏病的诊断。

caeses suspected coronary heart disease were conducted an electrocardiogram test of exercise load and observed for the dynamic change of P wave and amplitude. The results show as follow: among 72 cases, there are 35 cases S-T parts show ischemic change; 8(11.1%)cases-P wave amplitude increasing is tetween 1.0～1.8mm; 7(9. 72%)whose T and P equal in height and mix to come extent7 (9. 72%);P≥R. 4 whose P wave reveals mitral valve type P wave and the distance btween two peaks greater than 0.04S. The main manifestation is the connection of Ⅱ, Ⅲ and avF. Among 35 cases with positive reaction in the exercise load test, there are 7 who undergo the dynamic change of P wave, amount to 20%.It is my view that the dynamic change of P wave time and amplitude serves as a sensitve indicat or to the diagnosis of coronary heart disease and hypertensive heart disease.