食管心房超速负荷试验中QT间期离散度变化对冠心病的诊断价值

The role of QTd in transesophageal atrial superrate stimulation stress test for the diagnosis of coronary heart disease

目的探讨食管心房超速负荷试验的QT间期离散度 (QTd)对冠心病的诊断价值。方法对冠脉造影确诊为冠心病 38例及冠脉造影正常 4 0例进行食管心房超速负荷试验 ,记录试验前后 12导联心电图 ,测量ST段 ,校正QTc及QTd ,利用四格表法 ,分别计算各指标的特异性及敏感性。结果冠心病组试验后QTc及QTd均较试验前明显延长 (P<0 .0 1) ,试验后冠心病组QTd也长于非冠心病组 (P <0 .0 5 )。ST段 ,QTc及QTd诊断冠心病的特异性分别为 95 % ,6 7.5 % ,87.5 % ,敏感性分别为 5 2 .6 % ,73.7% ,84 .2 %。结论食管心房超速负荷试验的QT间期离散度 (QTd)能增加冠心病的诊断敏感度 ,对冠心病具有较高的诊断价值。

Objective To evaluate the diagnostic value of QTd in transesophageal atrial superrate stimulation test in the diagnosis of coronary heart disease(CHD). Methods Transesophageal atrial superrate stimulation stress test was performed in 38 CHD patients confirmed by coronary arteriography and 40 patients with normal manifestation of coronary arteriography. The simultaneous 12-lead ECG was recorded before and after test, meanwhile, ST segment was measured and QTc and QTd were corrected. The specificity and sensitivity of QTc and QTd was calculated by means of statistic crosstab method. Results QTc and QTd in CHD group were remarkably prolonged after test(P<0.01). After test, QTd in CHD group was longer than that of non-CHD group(P<0.05).The specificities of ST segment, QTc and QTd for diagnosing CHD were 95%, 67.5% and 87.5% , respectively. The sensitivities of ST segment, QTc and QTd were 52.6%, 73.7% and 84.2%, respectively. Conclusion QTd transesophageal atrial superrate stimulation stress test can increase the diagnostic sensitivity, which bears diagnostic value to CHD.