【摘要】 目的　研究经食管心房调搏负荷试验 (TEAPT)中 ,心率调整QTd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、每级起搏末的常规12导联心电图。测定每一时点心电图的QTd、QTcd值 ,计算QTcd/HR斜率 (SQTcd) ,并比较各项指标间及与ST段压低标准间的诊断效能。结果　冠心病 (CAD)组 (n =2 7)的负荷峰值QTd(QTdp)、峰值QTcd(QTcdp)、SQTcd值均显著大于冠脉无显著狭窄 (NCAD ,n =2 3)组 (t≥ 5 18,P <0 0 0 1) ,此 3个QTd有关参数在NCAD组的 95 %上限值分别为 6 0ms、95ms、0 74ms/bpm。以它们为界限值 ,此 3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 ) ,SQTcd的敏感性和准确性显著高于QTcdp及ST压低标准 (P <0 0 5 - 0 0 1)。结论　TEAPT可行、安全、无创 ,SQTcd是TEAPT诊断CAD的准确新指标更多还原

【Abstract】 The aim of the study was to demonstrate our hypothesis that QT dispersion (QTd)adjusted by heart rate could increase diagnostic power for coronary artery disease in transesophageal atrial pacing (TEAPT).Method TEAPT was performed in 50 cases before or after coronary arteriography within 1 week.12-leads ECG was recorded at rest and each grade end of TEAPT.QTd at rest (QTdr),QTd at load peak(QTdp),correct QTdr(QTcdr) and correct QTdp(QTcdp),Slope of QTcd/Heart rate (SQTcd)was measured and calculated respectively.Diagnostic power of these variables was compared.Results Twenty seven cases (CAD group)had coronary artery disease,23 cases had no significant stenosis (NCAD group).QTdp?QTcdp?SQTcd in CAD group was significant increased than that in NCAD group ( t≤5 18,P< 0 001),the 95% superior limit values was 60ms,90ms and 0.74ms/bpm respectively in NCAD group.Using the superior limit values as diagnostic criteria,then specificity of the 3 variables was significantly higher than that of ST depression( P <0.05);Sensitivity and accuracy of SQTcd was significantly higher than that of QTcdp and ST depression( P <0 05～0 01) Conclusion SQTcd has a very nice diagnostic power in stress and TEAPT is a safety,well-tolerated stress test for diagnosing coronary artery disease.更多还原