心绞痛患者食道心房调搏负荷试验的QTd变化

The change of QT dispersion in transesophageal atrial pacing stress test of patients with angina pectoris

目的研究经食管心房调搏负荷试验 (TEAPT)中 ,QTd及心率调整QTd指标对冠心病的诊断价值。方法 11例典型心绞痛患者 (AP组 )及 5 5例正常人 (对照组 )作TEAPT ,测算静息、峰值QTd(QTdr、QTdp)、△QTd/△HR指数 (IQTd) ,并比较它们与ST段压低标准对冠心病的诊断效能。结果AP组的QTdp、IQTd值均显著大于对照组 (t≥ 3 89,P <0 0 0 5 )。对照组QTdp、IQTd的 95 %上限值分别为 6 0ms、0 2 6ms bpm。以它们为界限值 ,QTdp的特异性、IQTd的特异性及准确性显著大于ST压低标准 (P <0 0 5 )。结论IQTd是TEAPT诊断冠心病的准确新指标。

Objective To study the change of QT dispersion (QTd) of patients with angina pectoris (AP) in transesophageal atrial pacing stress test (TEAPT). Methods TEAPT were performed in 11 patients with AP (AP group) and 55 normal persons (N group).. ST depression, QTd at rest (QTdr) and load peak (QTdp), ΔQTd/ΔHR (IQTd) was measured respectively. Diagnostic power of the variables was compared. Results ST depression, QTdp, IQTD in AP group were significantly increased than that in N group (P<0.005). Using the superior limit values as diagnostic criteria, that sensitivity, specificity and accuracy was 54.5%, 81.8%, 77.3% for St depression; 63.6%, 94.5%, 89.4% for QTdp; 81.8%, 94.5%, 92.4% for IQTd respectively. Specificity and accuracy of IQTd was signigicantly higher than that of ST depressions (P<0.05). Conclusion IQTd has a very nice diagnostic power in TEAPT.