平板运动试验中T波增高对诊断冠心病的意义

Risen T wave in exercise test and its value in diagnosis of coronary heart disease

目的探讨平板运动试验(treadmill exercise test,TET)过程中引起T波增高的特征、临床意义及其与冠状动脉病变的关系。方法分析36例在TET中出现T波增高患者的冠脉造影结果。结果 29例T波增高开始于运动中2～8 min,7例发生于运动后2～3 min,T波增高持续时间3～7 min;出现在V2、V3导联21例,V4导联9例,Ⅱ、Ⅲ、aVF导联6例。T波幅度V2导联0.8～2.0 mV,V3导联0.5～1.6 mV,V4导联0.6～1.3 mV,Ⅱ、Ⅲ、aVF导联0.4～0.8 mV。运动中发生心绞痛10例。36例均行冠脉造影术,全部出现冠状动脉狭窄病变,左前降支病变22例,前降支加右冠状动脉病变8例,右冠状动脉病变6例。行PTCA术36例,支架植入术27例。结论 TET中T波增高是冠状动脉病变存在的可靠阳性指标之一。

Objective To study the characteristics and clinical significance of the increase of T wave in electrocardiograms（ECG） during treadmill exercise test（TET）,and its relationship with coronary heart disease（CHD）.Methods 36 patients with risen T waves during or after TET were picked out from 2182 TET patients and received coronary angiography for analysis.Results 29 cases appeared great risen T waves during TET 2-8 min,other 7 cases appeared great risen T waves after TET 2-3 min and lasting 3-7 min.Among them,21 cases appeared risen T waves in V2 and V3,9 cases appeared in V4,2 cases appeared in inferior wall leads,the extent of T wave：V2 was 0.8-2.0 mV,V3 was 0.5-1.6 mV,V4 was 0.6-1.3 mV,inferior wall leadsⅡ,Ⅲ and aVF were 0.4-0.8 mV.10 cases got cardiac angina during exercise.All 36 cases received coronary angiography,22 cases had lesions on anterior descending branch,8 cases had lesions on anterior descending branch and right coronary artery and 6 cases had lesions on right coronary Artery.36 cases were performed PTCA and 27 cases received stent implantation.Conclusion Risen T wave induced by TET is one of the reliable positive indexes to predict the lesion of coronary artery.