运动后QTc间期改变与冠心病相关性分析

Correlation analysis of post-exercise changes of QTc interval and coronary artery diseases

观察64例患者运动试验前后各时间QTC变化情况和ST标准结果，并与冠脉造影结果作比较分析，结果显示冠脉正常组与冠脉病变组运动前QTc无明显差异，冠脉正常组运动后即刻、2、4分钟QTc较运动前缩短（分别P<0．01、P＜0．001、P＜0．05、），运动后6分钟QTC与运动前无显著差异（P＜0．05），冠脉病变组运动后即刻、2、4、6分钟均较运动前明显延长（P均＜0．001）。两组间对照，运动后QTC的各时间均有差异（P均＜0．001）。运动后QTc延长还与冠脉病变严重程度呈明显正相关，于ST标准比较，QTc对冠心病诊断的敏感性和特异性均优于前者。

The variations of the QTc interval and ST criteria as a result of exercise on 64 subjects, were studied.All subjects were submitted to percutaneous coronary angiography. Of the 64 persons studied, 33 had coronary arterydisease (CAD) and 31 were considered normal or showed non-significant lesions. The QTc interval on pre-exercise ECGwere similar between the normal group and the CAD. Comparing with the pre-exercise QTc, the QTc showed a shortening on the ECG at 0. 2 and 4 minute following execise in the normal group. However, prolongations of the QTc interval were recorded on ECG at 0.2, 4 and 6 minute after exercise in the CAD group. Regression analysis showed thatthe post-exercise prolongations of QTc correlated well with the seventy of CAG. Using post-exercise QTc variation >0. 014 second as an ischemic criteria, the sensitivity and specificity for CAD were 90. 9 % and 96. 8%, respectively, compared with 69. 7% and 67. 7% of the ST criteria. This study thus revealed that the QTc interval variations with exercisehave a value for the diagnosis of CAD.