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潘生丁负荷试验中QTd 诊断冠心病的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第1期
页码:
58-60
栏目:
论著
出版日期:
2002-01-01

文章信息/Info

Title:
QTd in stress test with combined dipyridamole and transesophageal atrial stimulation:Diagnostic value for coronary heart disease
作者:
王明空;  李春生;  岳全廷;  魏远亮
解放军152 医院心内科, 河南 平顶山 467000
Author(s):
WANG Ming-kong ; LI Chun-sheng ;  YUE Quan-ting ; WEI Yun-liang
Gospital 152, PLA , Pingdingshan,Henan 467000, China
关键词:
潘生丁食管心房调搏复合试验;  冠状动脉疾病;  QT 间期离散度;  心电描记术
Keywords:
stress test of combined dipyridamole and transesophageal atrial stimulation;  coronary disease; QT interval dispersion;  electrocardiography
分类号:
R541.22; R540.41　
DOI:
-
文献标识码:
A
摘要:
目的 观察冠心病患者潘生丁试验(DP2ECG) 及潘生丁食管心房调搏复合试验(TRAS-DP-ECG) 前、后心电图ST 段、校正Q T 间期(QTc) 及QT 间期离散度(QTd)的变化, 以评价TRAS-DP-ECG 诊断冠心病的价值。方法 对50例冠心病(CHD)患者(CHD组)及30例正常者(对照组) 进行DP-ECG 和TRAS-DP-ECG,记录试验前后12导联同步心电图, 测量其ST段,QTc及QTd。根据分布曲线求出QTc及QTd 的截断点。分别计算两种试验的敏感度、特异度及准确度。结果 如以QTd≥40ms 为截断点, 以DP-ECG 诊断CHD 时, 其敏感度、特异度、准确度分别为76% , 93% , 82%; 以TRAS-DP-ECG 诊断CHD 时, 其敏感度、特异度、准确度分别为92% , 93% , 92%。结论 TRAS-DP-ECG 时, 如以QTd≥40ms 为截断点, 可明显提高其诊断的敏感度及准确度而不影响其特异度。QTd≥40ms可作为TRAS-DP-ECG时诊断CHD的一项重要参考指标。
Abstract:
AIM To assess the value of QTc and QTd combined with ECG in dipyridamole test(DP-ECG) and stress test of combined dipyridamole and transesophageal at rial stimulation(TRAS-DP-ECG) in the diagnosis of coronary heart disease (CHD). METHODS 50 patients with CHD and 40 normal controls underwent DP-ECG and TRAS-DP-ECG. ST segment, QTc and QTd were measured in 12 lead synchronizing ECG recorded before and during the test. The cut-off value of QTc and QTd were calculated on ROC curve. The sensitivity, specificity and accuracy of the two tests were respectively calculated and then compared. RESULTS Using QTd≥40 ms as the cut-off value, the sensitivity, specificity and accuracy of the diagnosis for CHD in DP-ECG was 76% , 93% and 82% respectively,whereas the in TRAS-DP-ECG were 92% , 93% and 92% respectively. CONCLUSION The criteria of QTd≥40 ms during TRAS-DP-ECG might increase the sensitivity and accuracy of the diagnosis of CHD withent significantly decreasing the specificity, which suggests that QTd ≥ 40 ms during TRAS-DP-ECG might be used as an important index in the diagnosis of CHD.

参考文献/References

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[2] Josephson MA. Noninvasive detection and localization of coronary stenoses in patients: Comparison of resting dipyridamole and exercise thallium-201 myocardial perfusion imaging[J]. Am Heart J , 1982, 103: 1008-1010.

[3] 栾志和, 秦川秋, 王　丽, 等. 心电图潘生丁对冠心病早期诊断的研究[J]. 中华医学杂志, 1990, 70: 313- 314.

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备注/Memo

备注/Memo:
收稿日期：2001-06-25.
更新日期/Last Update: 2002-01-01