女性运动试验前后QT离散度变化对冠心病诊断的价值

摘要 探讨女性病人运动试验前、后QT离散度(QTd)的变化和其对冠心病诊断的价值。对临床上以胸痛为主诉的84例女性病人，先后行运动试验和冠状动脉造影检查，并测量运动试验前、后体表12导联心电图QTd。结果：在冠心病病人中，无论运动试验阳性还是阴性，运动试验后QTd明显大于运动试验前，差异有显著性(53.59±16.93 ms vs 32.05±14.18 ms,P＜0.01)；在非冠心病病人中运动试验前、后QTd无显著性差异(30.98±12.00 ms vs 29.27±12.33 ms,P＞0.05)。以运动试验后即刻和运动试验前QTd的差值≥20 ms作为指标，诊断冠心病的敏感性为87.18％、特异性为80.00％、准确性为83.33％。结果提示运动试验与QTd相结合可提高对女性冠心病诊断的敏感性、特异性和准确性。

The Significance of QT Dispersion During Exercise Stress Test in Women With Coronary Heart Disease

Kang Lianming,Zhang Youhua,Zhang Yan,et al

(Department of Cardiology,Cardiovascular Institute and Fuwai Hospital,Chinese Academy

of Medical Sciences and Peking Union Medical College,Beijing,100037)

Abstract To investigate the diagnostic value of QT dispersion in the interpretation of exercise stress test in women,QT dispersion of 12-lead surface ECG was analyzed in 84 women who had undergone exercise stress test and coronary angiography.Results:When compared with the pre-exercise value,the QT dispersion increased significantly after exercise stress test in women with coronary artery disease(53.59±16.93 ms vs 32.05±14.18 ms,P＜0.01),but not without coronary artery disease(30.98±12.00 ms vs 29.27±12.33 ms,P＞0.05).The increase of QT dispersion≥20 ms after exercise had a sensitivity of 87.18％,specificity of 80.00％,accuracy of 83.33％ for the diagnosis of coronary artery disease.Conclusion:QT despersion is significantly increased after exercise stress test in women with coronary artery disease.QT despersion could increase the sensitivity,the specificity and the accuracy of exercise testing in women for the diagnosis of coronary heart disease.