运动试验中QRSc延长对诊断冠心病的意义

The significance of QRS extended for diagnosis coronary heart disease during exercise treadmill test

目的 探讨运动后QRSc(心率校正QRS)变化对冠心病的诊断价值。方法 测定分析 86例病人 ,均进行活动平板试验及冠脉造影。 2 2例冠脉造影排除冠心病 ,其他 6 4例冠脉造影确定冠心病。对比二组受检者在运动前、运动后即刻、2分、4分、6分的QRSc改变。结果 冠脉正常组运动后QRSc缩短 ,冠心病组运动后QRSc延长 ,二组在运动前QRSc无显著差异 (P >0 0 5 )。运动后即刻、2分、4分、6分的QRSc均有非常显著差异 (P <0 0 1)。二组各自组内比较 ,运动前与运动后即刻无显著差异 (P >0 0 5 ) ,而与运动后 2分、4分、6分均有非常显著差异 (P <0 0 1)。结论 运动后QRS时限延长是心肌缺血的标志之一。平板运动试验时在测量ST段的同时 ,测量QRS时限 ,计算QRSc =QRS RR ,特别是运动后 2分以后的QRSc更有意义 。

Objective To evaluate the diagnostic value of the changes of QRS c(heart rate correct QRS) for coronary heart disease after exercise.Methods 86 cases of patients were tested and analyzed and each has completed exercise treadmill test and coronary angiography.22 cases of them were excluded from the coronary heart disease group through coronary angiography.The two groups of patients were compared on the changes of QRSc before and after exercise at 0 minute,2 minutes,4 minutes and 6 minutes respectively.Results QRS shortened in the non-coronary heart disease group and extended in the coronary heart disease group.QRS showed no difference before exercise in both groups(P>0.05) and significantly difference after exercise at 0,2,4 and 6 minutes respectively (P<0.01).Inside each group QRSc showed no difference occurred after exercise at 0 minute(P>0.05) and very significant difference occurred at 2,4 and 6 minutes after exercise (P<0.01).Conclusions The extended QRS after exercise is one of symbol of myocardial ischemia.It is very important to meacure the time limit of QRS and calculate the QRSc as well as ST during exercise treadmill test,especially the QRSc after 2 minutes after exercise.It can promote the positive rate and accuracy rate of earlier diagnosis myocardial ischemia for coronary heart disease patients.