中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
7期
589-592
,共4页
包明威%张逸杰%谭团团%周纪宁%杨剑雪%王芳%哈飞
包明威%張逸傑%譚糰糰%週紀寧%楊劍雪%王芳%哈飛
포명위%장일걸%담단단%주기저%양검설%왕방%합비
冠状动脉疾病%运动试验%QT滞后指数
冠狀動脈疾病%運動試驗%QT滯後指數
관상동맥질병%운동시험%QT체후지수
Coronary disease%Exercise test%QT hysteresis index
目的 探讨平板运动负荷试验(TET)中QT滞后指数在冠心病无创诊断中的价值.方法 连续选取100例因疑诊冠心病在我院行TET和选择性冠状动脉造影(SCA)的患者.根据SCA结果分为阳性组[55例,年龄(56.0±7.9)岁]和阴性组[45例,年龄(53.2±6.7)岁],分析TET心电图,每例测量50个点的RR间期、QTp间期和QTe间期.以RR间期为横坐标,QTp间期、QTe间期为纵坐标,作散点图和QT/RR曲线,计算QT滞后指数.结果 SCA阳性组的QTp滞后指数[(22.4±10.3)ms比(6.7 ±4.6)ms,P＜0.001]和QTe滞后指数[(27.1±11.1)ms比(7.6±4.6) ms,P＜0.001]明显高于阴性组.QTp或QTe滞后指数≥10 ms诊断冠心病的敏感性分别为89.1％ (49/55)和94.5％ (52/55),特异性分别为82.2％( 37/45)和80.0％( 36/45).若同时符合TET传统诊断标准和QT滞后诊断标准,诊断冠心病的敏感性QTp为94.3％ (33/35)、QTe为94.6％( 35/37),特异性二者均为100％.QTp滞后指数(r=-0.399,P＜0.001)和QTe滞后指数(r=-0.547,P＜0.001)与杜克平板评分显著相关.结论 QT滞后指数用于冠心病无创筛查具有较高的敏感性和特异性,与传统诊断标准结合,可提高平板运动负荷试验对冠心病的诊断效力.
目的 探討平闆運動負荷試驗(TET)中QT滯後指數在冠心病無創診斷中的價值.方法 連續選取100例因疑診冠心病在我院行TET和選擇性冠狀動脈造影(SCA)的患者.根據SCA結果分為暘性組[55例,年齡(56.0±7.9)歲]和陰性組[45例,年齡(53.2±6.7)歲],分析TET心電圖,每例測量50箇點的RR間期、QTp間期和QTe間期.以RR間期為橫坐標,QTp間期、QTe間期為縱坐標,作散點圖和QT/RR麯線,計算QT滯後指數.結果 SCA暘性組的QTp滯後指數[(22.4±10.3)ms比(6.7 ±4.6)ms,P＜0.001]和QTe滯後指數[(27.1±11.1)ms比(7.6±4.6) ms,P＜0.001]明顯高于陰性組.QTp或QTe滯後指數≥10 ms診斷冠心病的敏感性分彆為89.1％ (49/55)和94.5％ (52/55),特異性分彆為82.2％( 37/45)和80.0％( 36/45).若同時符閤TET傳統診斷標準和QT滯後診斷標準,診斷冠心病的敏感性QTp為94.3％ (33/35)、QTe為94.6％( 35/37),特異性二者均為100％.QTp滯後指數(r=-0.399,P＜0.001)和QTe滯後指數(r=-0.547,P＜0.001)與杜剋平闆評分顯著相關.結論 QT滯後指數用于冠心病無創篩查具有較高的敏感性和特異性,與傳統診斷標準結閤,可提高平闆運動負荷試驗對冠心病的診斷效力.
목적 탐토평판운동부하시험(TET)중QT체후지수재관심병무창진단중적개치.방법 련속선취100례인의진관심병재아원행TET화선택성관상동맥조영(SCA)적환자.근거SCA결과분위양성조[55례,년령(56.0±7.9)세]화음성조[45례,년령(53.2±6.7)세],분석TET심전도,매례측량50개점적RR간기、QTp간기화QTe간기.이RR간기위횡좌표,QTp간기、QTe간기위종좌표,작산점도화QT/RR곡선,계산QT체후지수.결과 SCA양성조적QTp체후지수[(22.4±10.3)ms비(6.7 ±4.6)ms,P＜0.001]화QTe체후지수[(27.1±11.1)ms비(7.6±4.6) ms,P＜0.001]명현고우음성조.QTp혹QTe체후지수≥10 ms진단관심병적민감성분별위89.1％ (49/55)화94.5％ (52/55),특이성분별위82.2％( 37/45)화80.0％( 36/45).약동시부합TET전통진단표준화QT체후진단표준,진단관심병적민감성QTp위94.3％ (33/35)、QTe위94.6％( 35/37),특이성이자균위100％.QTp체후지수(r=-0.399,P＜0.001)화QTe체후지수(r=-0.547,P＜0.001)여두극평판평분현저상관.결론 QT체후지수용우관심병무창사사구유교고적민감성화특이성,여전통진단표준결합,가제고평판운동부하시험대관심병적진단효력.
Objective To investigate the value of QT hysteresis index during treadmill exercise test (TET) in diagnosing coronary heart disease (CHD).Methods One hundred consecutive patients suspected for CHD were referred for TET and selective coronary angiography (CAG). Patients were divided into positive [n=55,age (56.0 ±7.9)years] and negative [n =45,age (53.2±6.7)years] group based on their CAG results.For each TET recording,50 points were selected for the RR,QTp,and QTe interval measurements.QTp and QTe interval was plotted against corresponding RR interval.QT/RR curve was constructed by connect all point,QT hysteresis index was calculated for each patient.Results The QTp [(22.4±10.3) msvs.(6.7±4.6) ms,P＜0.001] andQTe [(27.1 ±11.1) ms vs.(7.6±4.6)ms,P ＜ 0.001 ] hysteresis index of patients in positive group were significantly higher than those in negative group.The sensitivity of QTp and QTe hysteresis index for diagnosing CHD was 89.1％ (49/55) and 94.5 ％ ( 52/55 ),respectively,and the specificity was 82.2 ％ ( 37/45 ) and 80.0％ (36/45),respectively.If the patient fulfilled both the classical TET and QT hysteresis criteria,the sensitivity for diagnosing CHD increased to 94.3％ (33/35,QTp) and 94.6％ (35/37,QTe),and the specificity were both 100％ (26/26,26/26).Moreover,QTp ( r =- 0.399,P ＜ 0.001 ) and QTe ( r =- 0.547,P ＜ 0.001 ) hysteresis index highly correlated to Duke treadmill score.Conclusion QT hysteresis index is useful parameter for CHD diagnosis and which could improve the diagnostic value of TET for CHD in combination with the classical TET criteria for diagnosis of CHD.
