【摘要】 目的研究经食管心房调搏负荷试验 (TEAPT)中 ,QTd变化指标对冠心病的诊断价值。方法 5 0例研究对象在作冠状动脉造影术前后一周内进行TEAPT ,记录试验前及试验峰值末的常规 1 2导联心电图。测定静息及负荷峰值的QTd、QTcd(QTdr、QTcdr ,QTdp、QTcdp) ,计算QTdp与QTdr差值(QTdp r)及QTcdp与QTcdr差值 (QTcdp r) ,并比较此各项指标间及与ST段压低标准间的诊断效能。结果冠心病 (CAD)组 (n =2 7)的QTdp、QTcdp、QTdp r、QTcdp r值显著大于冠脉正常 (NCAD ,n =2 3)组(t≥ 5 38,P <0 0 0 1 ) ,此 4个QTd有关参数在NCAD组的 95 %上限值分别为 6 0ms、95ms、2 0ms、5 5ms。以它们为界限值 ,4个参数诊断冠心病的特异性均显著大于ST压低标准 (P <0 0 5 ) ,QTdp r的敏感性显著高于ST压低标准 (P <0 0 5 ) ,准确性显著高于QTcdp、QTcdp r及ST压低标准 (P <0 0 5～ 0 0 1 )。结论QTdp r是TEAPT诊断CAD的准确新指标。更多还原

【Abstract】 Objective To study the changes of QT dispersion (QTd) and its diagnostic value for coronary artery disease in transesophageal atrial pacing stress test (TEAPT). Methods TEAPT was performed in 50 cases before or after coronary arteriography within 1 week. 12-lead ECG was recorded at rest and peak end in TEAPT. QTd at rest (QTdr), QTd at load peak (QTdp), correct QTdr (QTcdr), correct QTdp (QTcdp), QTdp QTdr (QTdp-r) and QTcdp QTcdr (QTcdp r) were measured and calculated respectively. Diagnostic power of the variables were compared. Results 27 cases (CAD group) had coronary artery disease, 23 cases had no significant stenosis (NCAD group). QTdp, QTcdp, QTdp r, QTcdp r in CAD group were significant increased than that in NCAD group ( P <0.001), the 95% superior limit values were 60ms, 95ms, 20ms and 55ms respectively in NCAD group. Using the superior limit values as diagnostic criteria, then specificity of the 4 variables was significantly higher than that of ST depressions ( P <0.05); accuracy of QTdp r was significantly higher than that of QTcdp, QTcdp r and ST depression ( P <0.05～0.01). Conclusion QTdp r was new accuracy index in diagnosing CAD.hevalueofQTdispersionfordi更多还原