摘要
目的 探讨 QT离散度 (QTd)诊断心绞痛的价值及其诊断指标。方法 记录 2 7例肯定冠心病 ,41例临床诊断心绞痛和 16例正常对照者阵发性胸痛发作前 ,时及后 30 min内的 12导联体表心电图 ,测定它们的 QTd及校正的 QTd(QTcd)。结果 (1)肯定冠心病组和心绞痛组的 QTd,及 ST段压低在胸痛发作时较发作前明显增大 ,胸痛缓解后则恢复至接近正常水平。 (2 )对急性心肌缺血的诊断阳性率 QTd的 5个指标均高于缺血性 ST段压低 ,QTd增大至 5 0 %兼达到 80 m s诊断心绞痛的敏感性为81.5 % ,特异性为 10 0 %。结论 冠心病阵发性胸痛发作时 QTd明显增大 ,以胸痛发作时 QTd增大5 0 %兼达到 80 ms作为判断急性心肌缺血的 QT离散度标准较为合适。
Objective The study was aimed to investigate the value and indexes of QT dispersion(QTd) in diagnosing angina pectoris(AP).Methods The 12-lead electrocardiograme(ECGs) were recorded in 27 patients with confirmed coronary artery disease,41 patients with angina pectoris proved by clinical features,16 healthy indiveduals as control before and at the onset of paroxysmal chest pains,and within 30 minutes after the chest pains were released.The QTd and corrected QTd(QTcd) were measured.Results (1)During the onset of paroxysmal chest pains,the values of QTd and the ST segment depression of the patients with CAD and AP increased significantly than that before onset of chest pain,and decreased significantly after remission of the chest pains,and recovered to the levels before onset of chest pains.(2)The positive rate of QTd in diagnosing acute myocardial ischemia was more high than that of ischemic ST segment depression.The segment depression.The sensitivity and specificity of QTd increasing by≥50% and reaching 80ms were 81.5% and 100% respectively for diagnosing angina pectoris.Conclusion During the onset of paroxysmal chest pains in patients with coronary artery disease,the QTd increase significantly.When their chest pains come,it was suitable to take the indexes that QTd increasing by≥50% and reaching 80ms as a standard to judge acute myocardial ischemia.
出处
《临床心电学杂志》
2000年第3期135-138,共4页
Journal of Clinical Electrocardiology
关键词
QT离散度
冠心病
急性心肌缺血
诊断
QT dispersion Coronary artery disease Acute myocardial ishemia
