冠状动脉慢血流患者运动负荷试验QT离散度变化

Changes of QT Dispersion During Exercise Load Test in Patients with Coronary Slow Flow

目的探讨运动负荷试验对冠状动脉慢血流(CSF)患者QT离散度的影响。方法选取因胸痛行冠状动脉造影术、冠状动脉无明显狭窄(管腔直径狭窄<40%)且发现CSF的患者81例为慢血流组,选取冠状动脉造影正常且心电图运动负荷试验阴性者80例为对照组。计算每例运动前后的最大校正QT间期(QTcmax)、最小校正QT间期(QTcmin)及校正QT离散度(QTcd)。结果静息时慢血流组QTcmax较对照组明显延长(P<0.05),两组QTcmin无明显差异,慢血流组QTcd较对照组明显增大(P<0.05);运动后慢血流组QTcmax和QTcmin均较对照组明显延长(P<0.05),且QTcd较对照组明显增大(P<0.05)。慢血流组只有9名运动负荷试验阳性,占11.11%。慢血流组运动后QTcd较静息时明显减小(46.41±12.21 ms比62.81±17.18 ms,P<0.05),对照组运动前后QTcd无明显变化。结论 CSF患者QTcd较正常增大,运动会使其明显减小。

Aim To investigate the effect of exercise load test on QT dispersion in patients with coronary slow flow（ CSF）. Methods 81 cases of CSF patients with chest pain underwent coronary angiography,without coronary artery obvious stenosis（ stenosis of the lumen diameter 40%） were selected as the slow blood flow group. 80 cases with normal coronary angiography and exercise load test electrocardiogram negative were selected as the control group. Maximum corrected QT interval（ QTcmax）,minimum corrected QT interval（ QTcmin） and corrected QT dispersion（ QTcd） were calculated for each case before and after exercise. Results At rest time,QTcmaxin the slow blood flow group was significantly longer than that in the control group（ P〈0. 05）,the QTcd of the slow blood flow group increased significantly compared with the control group（ P〈0. 05）,but there was no significant difference in QTcminbetween the two groups.After exercise,the QTcmaxand QTcminin the slow blood flow group were significantly longer than those in the control group（ P〈0. 05）,and QTcd significantly increased compared with the control group（ P〈0. 05）. In the slow blood flow group,only 9 cases of exercise load test were positive,accounting for 11. 11%. After exercise,the QTcd was significantly decreased compared with rest in the slow blood flow group（ 46. 41 ± 12. 21 ms vs 62. 81 ± 17. 18 ms,P〈0. 05）. In the control group,there was no significant change of QTcd before and after exercise. Conclusion QTcd in CSF patients is higher than that in normal person,and the exercise will make it significantly reduced.