多巴酚丁胺负荷试验QTcd对冠心病的诊断价值

Diagnostic Value of QTc Dispersion during Dobutamine Stress Test in Patients with Coronary Heart Disease

目的探讨多巴酚丁胺负荷试验前、后冠心病与非冠心病患者QTc散离度(QTcd)的变化,评估多巴酚丁胺负荷试验QTcd对冠心病的诊断价值。方法测量选择性冠脉造影证实的30例冠心病与20例非冠心病患者试验前、后QTcd值,并比较分析。结果冠心病组多巴酚丁胺负荷试验终点QTcd明显高于试验前QTcd(P<0.01),非冠心病组无明显差异(P>0.05)。多巴酚丁胺负荷试验终点QTcd≥55ms诊断冠心病的敏感性、特异性、准确性分别为83.3%、85%、84%,QTcd≥10ms(86.7%、85%、86%)高于传统试验ST段压低诊断冠心病的价值(56.7%、50%、54%)(P<0.05)。结论多巴酚丁胺负荷试验QTcd、QTcd可提高冠心病的诊断价值,是一种安全、简便、有效的无创检查方法。

Objective To investigate the variance of QTc dispersion(QTcd)in patients with or without coronary heart disease(CHD)and evaluate the diagnostic value of QTcd in patients with CHD by Dobutamine Stress Test(DST).Methods DST ECGs were analyzed in50patients including20patients without coronary stenosis and30patients with CHD(Diagnosis based on≥50%diameter narrowing of a major coronart artery or its major branch)undergone DST and coronary angiographies for clinical diagnosis.QTcd was measured before and after DST.Results QTcd in patients with CHD after DST was higher than than of patients without CHD(P<0.01)and that before DST(P<0.01).QTcd of patients without CHD had no significant difference(P>0.05)between before DST and after DST.The diagnostic value of QTcd of≥55ms after DST has sensitivity of83.3%,Specificity of85%,accuracy of84%andQTcd of≥10ms (86.7%,85%,86%),respectively for the diagnosis of patients with CHD.They were higher than that of ST-segment depression≥1mV(56.7%,50%,54%),respectively during stress(P<0.05).There were no significant difference between the diagnostic value of QTcd after DST and that ofQTcd(P>0.05).conclusion QTcd andQTcd during DST can improve the diagnostic value of CHD.[