摘要 为了解QT离散度(QTd)在运动试验中的变化对冠心病心肌缺血的诊断价值，对30例临床诊断或疑诊为冠心病的病人先后行平板运动试验(简称运动试验)及冠状动脉(简称冠脉)造影检查。17例运动试验阳性者中10例确诊为冠心病；13例运动试验阴性者中10例冠状动脉正常。运动试验诊断冠心病的敏感性76.9%、特异性58.8%、准确性66.7%。冠心病组与冠脉正常组运动前、中、后QTd分别为46.25±20.13 ms、71.92±20.37 ms、51.25±14.48 ms及32.35±6.64 ms、30.88±9.23 ms、29.38±8.54 ms，两者比较，P均<0.01。冠心病组运动前、后与运动中QTd比较，差异有显著性，P<0.005；而冠脉正常组QTd变化无显著性。以运动中QTd≥60 ms为异常，诊断冠心病的敏感性为92.3%、特异性100%、准确性96.7%。提示运动试验中QTd增加可作为诊断冠心病心肌缺血的敏感而特异的指标。

    

Diagnostic Value of QT Dispersion for Coronary Artery Disease in Exercise Treadmill Test

Ge Yonggui,Zhang Qunlin, Wang Wei, et al

(Department of Cardiology, Taihe Hospital, Shiyan City, Hubei Province,442000)

Abstract To evaluate the diagnostic value of QT dispersion (QTd) for coronary artery disease (CAD) in exercise treadmill test (ETT),30 patients (mean age 51.7 years, 20 males) suspected CAD were underwent ETT and coronary angiography sequentially.The QTd in 12-lead surface ECG before,during and post exercise was measured in every patients.CAD was established in 10 of 17 patients with positive exercise test.10 of 13 patients with negative ETT had normal coronary artery. The sensitivity,specificity and accuracy of ETT by ST segment depression for diagnosis of CAD was 76.9%,58.8% and 66.7%, respectively. QTd was significantly increased in patients with CAD before, during and post exercise (46.25±20.13 ......