运动试验QRS延长、QTd及ST下移对冠心病诊断价值的对比研究

Comparative study of QRS prolongation,QT dispersion and ST segment depression in the diagnosis of coronary heart disease during exercise treadmill testing

目的 比较运动试验中QRS延长、QT离散度 (QTd)及传统的ST下移标准对冠心病心肌缺血的诊断价值。方法 观察 6 6例冠心病患者及 30例正常人平板运动试验前后QRS时限、QTd和ST段的变化。结果 冠心病组运动后QRS时限、QTd明显增加 (P <0 .0 1) ,其增加程度与ST压低值之间呈显著正相关性 (P均 <0 .0 1)。QRS延长≥ 8ms和QTd≥ 6 0ms对冠心病诊断的特异性和阳性预测值均优于传统的ST诊断标准。

Objective To compare the diagnostic value of QRS prolongation, QT dispersion and ST segment depression for coronary heart disease during exercise treadmill testing.Methods The changes of QRS prolongation, QT dispersion and ST segment depression on resting and peak exercise treadmill test were analysed in 66 patients with coronary heart disease.Results Both QRS duration and QT dispersion were significantly increased with cxercise. The increases of QRS duration and QT dispersion were positively correlated with ST segment depression. Compared with ST segment depression analysis ,the specificity of QRS prolongation of ≥8msec and QTd≥60msec were higher and the sensitivity were lower.Conclusions The QRS prolongation and QT dispersion were a new accurate indexes in diagnosing myocardial ischemia of patients with coronary heart disease.