平板运动试验中校正Q-T间期离散度变化的意义及其与ST段下移对冠心病诊断价值的对比研究

Significance of corrected QT interval dispersion changes in exercise treadmill testing and comparative study of ST segment depression and QT interval in the diagnosis of coronary heart disease

目的:研究活动平板运动试验前后校正Q-T间期离散度的变化及其意义,并且比较其与ST段下移对冠心病的诊断价值。方法:分析比较冠心病及正常对照组活动平板运动前后各时相QTcd及ST段变化。分析74例冠状动脉造影检查的患者平板运动试验前后各时相QTcd动态变化,计算以运动后即刻QTcd≥50ms可作为运动试验阳性的判断标准的临床价值,并与ST段下移标准的价值进行对照。结果:运动后冠心病组QTcd比对照组明显升高,与ST段下移标准比较,敏感性,特异性,准确性均高于后者。结论:运动试验后QTcd≥50ms的标准对冠心病的诊断具有重要的意义。

Objective To study the changes and clinical value of corrected QT interval（QTc） before and after exercise treadmill testing（ETT）,and compare the diagnostic value of corrected QT dispersion（QTcd） and ST segment depression for coronary heart disease（CHD）.Method Seventy-four patients,who had experienced ETT and coronary angiography（CAG） in the same period were devided into CHD group and NCHD group.QTc of 12-lead surface ECG was measured before and after ETT.△QTc（△QTc = immediate QTc after ETT-QTc before ETT） ≥50 ms was thought of as positive,and its diagnostic value was compared with ST segment.Results △QTc was higher in CHD group after ETT.Conclusion with ST segment depression analysis,the specificity and accuracy of QTcd≥50 ms were higher.Conclusion QTc after ETT gets better in patients with CHD.QTcd≥50 ms can be a sensitive and specific index of diagnosis of CHD.