冠心病病人运动试验时QRS间期延长与冠脉狭窄关系探讨

Studies on the Correlation between Coronary Artery Stenosis and QRS Interval Lengthening During Exercise Test in Coronary Heart Disease Cases

目的探讨冠心病病人心肌缺血时QRS间期的变化及其与冠脉狭窄的关系 ,并结合现有资料探讨其可能机制。方法120名患者分别于1月内予心导管检查及蹬车心电图运动试验。结果30名患者冠脉造影正常 ,90名有冠脉狭窄病变。正常者运动时QRS间期缩短 (-2.9ms,可信区间 -6.0至0.2) ,而冠脉狭窄者运动时QRS间期延长。运动诱发QRS间期延长与冠脉狭窄支数相关 ,(4.5ms/1支 ,7.9mg/2支 ,13.4ms/3支 ,P<0.01)。结论运动可导致冠脉狭窄者QRS间期延长 ,并与心肌缺血有关。QRS间期延长可作为运动诱发心肌缺血的标志。

Objective To observe the changes of QRS interval and its correlation to the stenosis of coronary arteries in the ischemic stage of the coronary heart disease cases so as to explore the possible mechanisms based on the clinical data. Methods 120 cases were examined with cardiac catheterization and cycle ergometer test. Results 30 cases showed normal coronary arteriongraphy and 90 cases showed stenosed coronary arteries. QRS interval was shortened in the normal cases (-2.9ms with reliable span of -0.6 to 0.2), while in the coronary stenosed cases QRS interval was lengthened. Positive correlation was observed between the QRS interval lengthening and stenosed branches of the coronary arteries (4.5ms/1 branch of stenosed coronary artery, 7.9ms/2 branches, 13.4ms/ 3 branches, P<0.01). Conclusion Exercises could induce QRS lengthening and was correlated to the ischemic conditions of the myocardium, which could serve as an index for the exercise-induced myocardial ischemia.