女性运动试验前后QT离散度变化对冠心病诊断的价值

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±１６．９３ｍｓｖｓ３２．０５±１４．１８ｍｓ，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±１２．００ｍｓｖｓ２９．２７±１２．３３ｍｓ，Ｐ＞０．０５）。以运动试验后即刻和运动试验前ＱＴｄ的差值≥２０ｍｓ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

To investigate the diagnostic value of QT dispersion in the interpretation of exercise stress test in women,QT dispersion of 12lead surface ECG was analyzed in 84 women who had undergone exercise stress test and coronary angiography.Results:When compared with the preexercise value,the QT dispersion increased significantly after exercise stress test in women with coronary artery disease(53.5916.93 ms vs 32.0514.18 ms,P<0.01),but not without coronary artery disease(30.9812.00 ms vs 29.2712.33 ms,P>0.05).The increase of QT dispersion20 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.