【摘要】 目的　探讨区域性QT间期差值 (QTrd)能否作为鉴别高血压和冠心病两种不同疾病引起的心肌缺血的一个指标。方法　将 98例因体表心电图出现ST段异常改变 ,经冠状动脉造影确诊为冠心病、高血压病病例分为冠心病组、高血压并冠心病 (CH)组、高血压组。把体表十二导心电图分为I、aVL ,Ⅱ、Ⅲ、aVF ,V2～ 4 ,V5～ 6四个区域 ,测量各区域的QTrd并进行分析和比较。结果　在I、aVL区域 ,各组都有部分QTrd≥ 40ms ;Ⅱ、Ⅲ、aVF ,V2～ 4 ,V5～ 6三个区域 ,有一个区域的QTrd≥ 40ms的百分比 ,在高血压组为 81%,CH组 5 2 %,冠心病组无一例大于 40ms。结论　高血压病时 ,如心电图出现ST段异常改变 ,在Ⅱ、Ⅲ、aVF ,V2～ 4 ,V5～ 6这三个区域中 ,有一区域的QTrd大于 40ms,则心肌肥厚伴缺血的可能性大 ,如这三个区域中的QTrd都小于 40ms ,可能为冠状动脉病变引起的心肌缺血的表现。更多还原

【Abstract】 Objective To analyze whether regional QTrd could be an index to identify myocardial ischemia caused by hypertension or coronary heart disease(CHD). Methods According to the changes of ST segment in ECG and coronary arteriongraphy, 98 cases were divided into three groups: coronary heart disease (C) group, hypertension with coronary heart disease(CH)group and hypertension (H) group. QTrd was measured and compared in four regions (lead I and AVL, lead II, III and AVF,lead V 2～4 and lead V 5～6 )in ECG of each group. Results QTrd≥40 ms was seen in all three groups in the region of lead I and AVL. The rate of QTrd≥40 ms in one of the other three regions was 81%, 52% and 0% in group H, CH and C respectively. Conclusion In hypertension, myocardial hypertrophy with ischemia was highly possible if there was QTrd≥40 ms in any one of the three regions (II, III and AVF, V 2～4 , V 5～6 );if the QTrd≤40 ms in these all three regions myocardial ischemia may be caused by coronary disease.更多还原