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心得安食管心房超速负荷试验中QTd诊断冠心病的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第3期
页码:
234-236
栏目:
临床研究
出版日期:
2004-05-01

文章信息/Info

Title:
QTd in stress test with combined propanolol and transesophageal atrial stimulation diagnostic value for coronary heart disease
作者:
王明空李春生魏运亮宗书峰
解放军152医院心内科,河南 平顶山 467000
Author(s):
WANG Ming-kongLI Chun-shengWEI Yun-liangZONG Shu-feng
152 of Hospital,PLA, Pingdingshan,Henan 467000,China
关键词:
心得安食管心房超速负荷试脸冠状动脉疾病QT间期离散度心电描记术
Keywords:
combined propanolol and transesophageal atrial stimulation coronary artery disease QT intervald ispersion electrocardiography
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察患者食管心房超速负荷试验(TRAS-ECG)及心得安食管心房超速负荷试验(TRAS-Prop-ECG)前后心电图校正QT间期(QTc)及QT间期离散度(QTd)的变化,以评价TRAS-Prop-ECG诊断冠心病的价值。方法:对50例冠心病(CHD)患者(CHI〕组)及30例正常者(对照组)进行TRAS-ECG和TRAS-Prop-ECG试验,记录试验前后12导联同步心电图,测量其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>,40 rns为截断点,以TRAS-ECG诊断CHD时,其敏感度、特异度及准确度分别为7600.6700.73%;以TRAS-Prop-ECG诊断CHD时,其敏感度、特异度及准确度分别为9200,93%,93Y。结论:TRAS-Prop-ECG时,如以QTd>40 rns为截断点,可明显提高其诊断的敏感度、特异度及准确度。QTd>-40 ras可作为TRAS-Prop-ECG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 stress tests of transesophageal atrial stimulation (TRAS-ECG) and of combined propanolol and transesophageal atrial stimulation (TRAS-Prop-ECG) in the diagnosis of coronary heart disease(CHD). METHODS:50 CHD patients and 30 normal controls underwent TRAS-ECG and TRAS-Prop-ECG. 12 lead synchronizing ECG was recorded and QTc and QTd were measured 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 TRAS-ECG were 760 %, 67 % and 730 % espectively,and those in TRAS-Prop-ECG were 92 %,93 % and 93 % respectively. CONCLUSION: The criteria of QTd>40 ms during TRAS-Prop-ECG might increase the sensitivity,specificity and accuracy of the diagnoisis of CHD,surggesting that QTd>40 ms during TRAS-Prop-ECG might be used as an improtant index in the diagnosis of CHD.stress test

参考文献/References

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[2] 蒲岷. 现代心脏病诊治技术[M]. 成都:成都出版社, 1992. 1-20.

[3] 位伟, 侯华丽. 三种心脏负荷试验对冠心病诊断价值的对比研究[J]. 临床心血管病杂志, 1998,14:84-85.

[4] Hii JTY, Wyse DG, Gillis AM, et al. Precordial QT interval dispertion as a marker of torsades de pointes. Disparate effects of class IA antiarrhythmic drugs ans amiodarone[J]. Circulation, 1992,86:1376-1382.

[5] 张建英, 志永明. 不同临床类型冠心病的QTc离散度[J]. 中国心脏起搏与心电生理杂志, 1997,11:30-31.

备注/Memo

备注/Memo:
收稿日期:2003-5-12
更新日期/Last Update: 2004-05-01